Organization
CIAMPA ORAL SURGERY, P.S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PETER R. CIAMPA D.M.D. (PRESIDENT)
(270) 442-4374
Entity
Organization
Contact information
Practice address
200 MEDICAL CENTER DR, PADUCAH, KY 42003-7911
(270) 442-4374
(270) 442-1878
Mailing address
200 MEDICAL CENTER DR, PADUCAH, KY 42003-7911
(270) 442-4374
(270) 442-1878
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
5552
KY
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
5552
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
542505
UNITED CONCORDIA INS
KY
05
—
61900361
—
KY
05
—
65934044
—
KY
Enumeration date
03/02/2007
Last updated
08/16/2010
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