Individual
DR. CREE KOFFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD,MD
Contact information
Practice address
550 S JACKSON ST FL 2, LOUISVILLE, KY 40202-1622
(502) 852-8990
(502) 852-8551
Mailing address
550 S JACKSON ST, 2ND FLOOR ORAL SURGERY CLINIC, LOUISVILLE, KY 40202-5831
(502) 852-8990
(502) 852-8551
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
9613
KY
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
DEN.00204643
CO
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
DR.0065744
CO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/20/2015
Last updated
03/23/2021
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