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Organization
SOUTHERN KENTUCKY ORAL SURGERY ASSOCIATES PLLC
Active
Organization
SOUTHERN KENTUCKY ORAL SURGERY ASSOCIATES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICKIE ALVEY (CREDENTIALING COORDINATOR)
(270) 783-0064
Entity
Organization
Contact information
Practice address
1802 ROCKINGHAM AVE, BOWLING GREEN, KY 42104-3348
(270) 783-0064
Mailing address
1802 ROCKINGHAM AVE, BOWLING GREEN, KY 42104-3348
Taxonomy
Speciality
Code
Description
License number
State
1223P0106X
Oral and Maxillofacial Pathology Dentistry
—
NULL
1223P0106X
Oral and Maxillofacial Pathology Dentistry
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
NULL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
09/26/2007
Last updated
09/21/2021
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