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Organization
GEORGETOWN ORAL AND FACIAL SURGERY, LLC
Active
Organization
GEORGETOWN ORAL AND FACIAL SURGERY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. AMY CORNETTE HENDERSON (OFFICE MANAGER)
(859) 971-9722
Entity
Organization
Contact information
Practice address
101 DARBY DR, SUITE 101, GEORGETOWN, KY 40324-8715
(502) 863-5858
(859) 971-9722
Mailing address
972 FIDDLER CREEK WAY, LEXINGTON, KY 40515-6460
(859) 971-9722
(859) 971-9722
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
7379
KY
Other
Enumeration date
05/11/2009
Last updated
06/02/2009
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