# CENTRE ORAL & FACIAL SURGERY, P.C.

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

## Provider details

- **NPI number:** 1386692184
- **Authorized official:** GREGORY F KEWITT DMD, MD (OWNER/PRESIDENT)
- **Authorized official phone:** (814) 235-7700

## Contact information

- **Practice address:** 474 WINDMERE DR, SUITE 202, STATE COLLEGE, PA 16801-7668
- **Practice address phone:** (814) 235-7700
- **Practice address fax:** (814) 235-7633
- **Mailing address:** 474 WINDMERE DR STE 202, STATE COLLEGE, PA 16801-7643
- **Mailing address phone:** (814) 235-7700
- **Mailing address fax:** (814) 235-7633

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | DS029616L | PA | Yes |
| 204E00000X | Oral & Maxillofacial Surgery (D.M.D.) | MD073230L | PA | — |
| 2082S0099X | Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician | MD073230L | PA | — |

## Other

- **Enumeration date:** 05/04/2006
- **Last updated:** 04/18/2024