Organization
ABILEN ORAL AND MAXILLOFACIAL SURGERY ASSOCIATES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOE L KETHLEY JR. DDS (OWNER)
(325) 437-3100
Entity
Organization
Contact information
Practice address
4 HOSPITAL DR, ABILENE, TX 79606-5289
(325) 437-3100
(325) 437-3199
Mailing address
4 HOSPITAL DR, ABILENE, TX 79606-5289
(325) 437-3100
(325) 437-3199
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
10328
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
136335007
—
TX
Enumeration date
01/28/2014
Last updated
01/28/2014
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