# CIAMPA ORAL SURGERY, P.S.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1265561872
- **Authorized official:** DR. PETER R. CIAMPA D.M.D. (PRESIDENT)
- **Authorized official phone:** (270) 442-4374

## Contact information

- **Practice address:** 200 MEDICAL CENTER DR, PADUCAH, KY 42003-7911
- **Practice address phone:** (270) 442-4374
- **Practice address fax:** (270) 442-1878
- **Mailing address:** 200 MEDICAL CENTER DR, PADUCAH, KY 42003-7911
- **Mailing address phone:** (270) 442-4374
- **Mailing address fax:** (270) 442-1878

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 5552 | KY | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 5552 | KY | Yes |

## Other

- **Enumeration date:** 03/02/2007
- **Last updated:** 08/16/2010