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Organization
THAD R. SCHULTEN PSC
Active
Organization
THAD R. SCHULTEN PSC
Active
Parent organization
KENTUCKY CENTER FOR ORAL & MAXILLOFACIAL SURGERY
Other names
Kentucky Center for Oral & Maxillofacial Surgery, Kentucky Center for Oral & Maxillofacial Surgery PSC
Organization subpart
Yes
Provider details
NPI number
Legal business name
KENTUCKY CENTER FOR ORAL & MAXILLOFACIAL SURGERY
Authorized official
PENNY BOONE (OFFICE MANAGER)
(502) 361-0134
Entity
Organization
Contact information
Practice address
4515 CHURCHMAN AVE., LOUISVILLE, KY 40215
(502) 361-0134
(502) 361-0137
Mailing address
4515 CHURCHMAN AVE., LOUISVILLE, KY 40215
(502) 361-0134
(502) 361-0137
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
NULL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
07/25/2007
Last updated
09/11/2024
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