| NPI | 1205300290 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEWIS C JONES Oral Surgeon/Owner 502-897-0424 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2019-01-14 |
| Last Update Date | 2023-12-05 |