Provider Demographics
NPI:1629172853
Name:ORAL FACIAL SURGERY ASSOCIATES PSC
Entity Type:Organization
Organization Name:ORAL FACIAL SURGERY ASSOCIATES PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:SCHULER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:859-578-9000
Mailing Address - Street 1:330 THOMAS MORE PKWY
Mailing Address - Street 2:SUITE 101
Mailing Address - City:CRESTVIEW HILLS
Mailing Address - State:KY
Mailing Address - Zip Code:41017
Mailing Address - Country:US
Mailing Address - Phone:859-578-9000
Mailing Address - Fax:859-578-9815
Practice Address - Street 1:330 THOMAS MORE PKWY
Practice Address - Street 2:SUITE 101
Practice Address - City:CRESTVIEW HILLS
Practice Address - State:KY
Practice Address - Zip Code:41017-3427
Practice Address - Country:US
Practice Address - Phone:859-578-9000
Practice Address - Fax:859-578-9815
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-08
Last Update Date:2007-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY3022Medicare UPIN