NPI 1003388117

Drs Brock, Henderson, Di Prisco, Ravelo and Green INC

Organisation Oral and Maxillofacial Surgery (Dentist) Ashland, KY

Practice location

Address: 2301 Lexington Ave STE 120, Ashland, KY 41101-2807
Phone: (304) 399-1092
Mailing address: 103 Station Place Way, Hurricane, WV 25526-8747

Authorised official

Name: Lesley Marie Coyner
Title: Credentialing
Phone: (304) 345-1092

Registered specialties

Oral and Maxillofacial Surgery (Dentist) Primary

Dental Providers Taxonomy 1223S0112X

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Registry record

NPI: 1003388117
Entity type: Organization
NPI issued: 31 Dec 2018
Record last updated: 29 May 2025

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.