Organization
ORAL SURGERY GROUP - CORYDON LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN C JAMES (CFO)
(502) 254-8500
Entity
Organization
Contact information
Practice address
2086 OLD HWY 135 NW, 1, CORYDON, IN 47112-4016
(502) 254-8500
Mailing address
2086 OLD HWY 135 NW, 1, CORYDON, IN 47112-4016
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
04/14/2017
Last updated
04/14/2017
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