# TKR ORAL MAXILLOFACIAL SURGEONS CORPORATION

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

## Provider details

- **NPI number:** 1710518543
- **Authorized official:** KRSTAL KAY THOMPSON DDS (PRESIDENT)
- **Authorized official phone:** (304) 731-6688

## Contact information

- **Practice address:** 914 JOHNSTOWN RD, BECKLEY, WV 25801-4938
- **Practice address phone:** (681) 207-3959
- **Practice address fax:** (681) 207-3958
- **Mailing address:** 914 JOHNSTOWN RD, BECKLEY, WV 25801-4938
- **Mailing address phone:** (681) 207-3959
- **Mailing address fax:** (681) 207-3958

## Taxonomy

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

## Other

- **Enumeration date:** 01/30/2020
- **Last updated:** 01/30/2020