Organization
ORAL & MAXILLOFACIAL SURGERY PSC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WINFIELD C JOHN III DMD (PRESIDENT)
(606) 329-2219
Entity
Organization
Contact information
Practice address
2301 LEXINGTON AVE, STE 120, ASHLAND, KY 41101
(606) 329-2219
(606) 325-9997
Mailing address
2301 LEXINGTON AVE, STE 120, ASHLAND, KY 41101
(606) 329-2219
(606) 325-9997
Taxonomy
Speciality
Code
Description
License number
State
261QS0112X
Oral and Maxillofacial Surgery Clinic/Center
Primary
4340
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
60043403
—
KY
Enumeration date
09/07/2006
Last updated
08/22/2020
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