Organization
KENTUCKY CENTER FOR ORAL & MAXILLOFACIAL SURGERY PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS REDA S. VAUGHN (OFFICE ADMINISTRATOR)
(859) 278-9376
Entity
Organization
Contact information
Practice address
2424 SIR BARTON WAY STE 375, LEXINGTON, KY 40509-2747
(589) 207-4790
(859) 340-1928
Mailing address
3159 BEAUMONT CENTRE CIR STE 110, LEXINGTON, KY 40513-1968
(859) 278-9376
(859) 276-0260
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
07/10/2019
Last updated
09/29/2022
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