Organization · NPI-2

Alderdice Oral And Maxillofacial Surgeons

Dentist, Oral and Maxillofacial Surgery · Somerset, KY

NPI number1407298102
StatusActive
Last updated in NPPESJul 23, 2013

Details

NPI
1407298102
Entity type
Organization (NPI-2)
Legal business name
Alderdice Oral And Maxillofacial Surgeons
Organization subpart
No
Enumeration date
Jul 23, 2013
Last updated
Jul 23, 2013

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1223S0112X Dentist, Oral and Maxillofacial Surgery––Yes
122300000X Dentist4939KY

Practice location

100 Hardin Ln
Ste B
Somerset, KY 42503-3812

Phone 606-679-8568 · Fax 606-676-0868

Mailing address

100 Hardin Ln
Ste B
Somerset, KY 42503-3812

Phone 606-679-8568 · Fax 606-676-0868

Authorized official

Bennie Alderdice
Owner
6066798568

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