Organization
ANDERSON ORAL AND MAXILLOFACIAL SURGERY, P.S.C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEVEN ANDREW ANDERSON D.M.D. (ORAL AND MAXILLOFACIAL SURGEON)
(606) 878-6126
Entity
Organization
Contact information
Practice address
1675 S MAIN ST, LAUREL MEDICAL CENTER, LOWER LEVEL, LONDON, KY 40741-2050
(606) 878-6126
(606) 878-0840
Mailing address
1675 S MAIN ST, LAUREL MEDICAL CENTER, LOWER LEVEL, LONDON, KY 40741-2050
(606) 878-6126
(606) 878-0840
Taxonomy
Speciality
Code
Description
License number
State
261QS0112X
Oral and Maxillofacial Surgery Clinic/Center
Primary
6656
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64066566
—
KY
Enumeration date
02/21/2012
Last updated
02/21/2012
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