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Organization
COMMONWEALTH ORAL AND MAXILLOFACIAL SURGERY, PSC
Active
Organization
COMMONWEALTH ORAL AND MAXILLOFACIAL SURGERY, PSC
Active
Other names
Commonwealth Oral Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIMOTHY ACORD D.D.S. (OWNER, PRESIDENT)
(502) 423-7822
Entity
Organization
Contact information
Practice address
6520 GLENRIDGE PARK PL, SUITE 7, LOUISVILLE, KY 40222-3455
(502) 423-7822
(502) 423-7830
Mailing address
6520 GLENRIDGE PARK PL, SUITE 7, LOUISVILLE, KY 40222-3455
(502) 423-7822
(502) 423-7830
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
8588
KY
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
8588
KY
Other
Enumeration date
06/23/2015
Last updated
06/23/2015
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