Provider Demographics
NPI:1689304404
Name:ORAL SURGERY & IMPLANT ASSOCIATES
Entity Type:Organization
Organization Name:ORAL SURGERY & IMPLANT ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OMS
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:SEXTON
Authorized Official - Suffix:
Authorized Official - Credentials:DMD, MD
Authorized Official - Phone:859-744-0677
Mailing Address - Street 1:25 E HIGH ST STE 1
Mailing Address - Street 2:
Mailing Address - City:MT STERLING
Mailing Address - State:KY
Mailing Address - Zip Code:40353-1267
Mailing Address - Country:US
Mailing Address - Phone:859-498-6204
Mailing Address - Fax:859-498-6205
Practice Address - Street 1:25 E HIGH ST STE 1
Practice Address - Street 2:
Practice Address - City:MT STERLING
Practice Address - State:KY
Practice Address - Zip Code:40353-1267
Practice Address - Country:US
Practice Address - Phone:859-498-6204
Practice Address - Fax:859-498-6205
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-14
Last Update Date:2022-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty
No204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial SurgeryGroup - Multi-Specialty