| NPI | 1831292226 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WINFIELD C JOHN President 606-329-2219 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery (Licence: KY 4340) |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2020-08-22 |