Organization
COMMONWEALTH ORAL AND MAXILLOFACIAL SURGERY, PSC
Active
Other names
Commonwealth Oral Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIMOTHY ACORD D.D.S. (OWNER, PRESIDENT)
(502) 423-7822
Entity
Organization
Contact information
Practice address
6520 GLENRIDGE PARK PL, SUITE 7, LOUISVILLE, KY 40222-3455
(502) 423-7822
(502) 423-7830
Mailing address
6520 GLENRIDGE PARK PL, SUITE 7, LOUISVILLE, KY 40222-3455
(502) 423-7822
(502) 423-7830
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
8588
KY
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
8588
KY
Other
Enumeration date
06/23/2015
Last updated
06/23/2015
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