# OWENSBORO CENTER FOR ORAL & MAXILLOFACIAL SURGERY, PLLC

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

## Provider details

- **NPI number:** 1871724914
- **Authorized official:** DR. WILLIAM DOUGLAS SHAVER D.M.D. (OWNER)
- **Authorized official phone:** (270) 926-6100

## Contact information

- **Practice address:** 2816 VEACH RD, OWENSBORO, KY 42303-6295
- **Practice address phone:** (270) 926-6100
- **Practice address fax:** (270) 926-6195
- **Mailing address:** 2816 VEACH RD, OWENSBORO, KY 42303-6295
- **Mailing address phone:** (270) 926-6100
- **Mailing address fax:** (270) 926-6195

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 4637 | KY | Yes |

## Other

- **Enumeration date:** 08/06/2009
- **Last updated:** 08/06/2009