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Organization
THE IMPLANT AND ORAL SURGERY CENTER, LLC
Active
Organization
THE IMPLANT AND ORAL SURGERY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DONALD R. MCLAURIN DMD, MD (ORAL SURGEON)
(859) 498-6204
Entity
Organization
Contact information
Practice address
204 BEVINS LN, SUITE F, GEORGETOWN, KY 40324-6139
(502) 863-1402
(502) 863-1405
Mailing address
204 BEVINS LN, SUITE F, GEORGETOWN, KY 40324-6139
(502) 863-1402
(502) 863-1405
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
NULL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
—
NULL
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
—
—
Other
Enumeration date
06/09/2009
Last updated
06/23/2009
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