# ALDERDICE ORAL AND MAXILLOFACIAL SURGEONS

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

## Provider details

- **NPI number:** 1407298102
- **Authorized official:** DR. BENNIE ALDERDICE SR. D.M.D. (OWNER)
- **Authorized official phone:** (606) 679-8568

## Contact information

- **Practice address:** 100 HARDIN LN, STE B, SOMERSET, KY 42503-3812
- **Practice address phone:** (606) 679-8568
- **Practice address fax:** (606) 676-0868
- **Mailing address:** 100 HARDIN LN, STE B, SOMERSET, KY 42503-3812
- **Mailing address phone:** (606) 679-8568
- **Mailing address fax:** (606) 676-0868

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 4939 | KY | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | Yes |

## Other

- **Enumeration date:** 07/23/2013
- **Last updated:** 07/23/2013