Organization Name:  GREGORY R. ERENA, P.S.C.


Practice Location:
620 PERIMETER DR STE 100 LEXINGTON, KY 40517 US
Tel: 859-268-4423  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

Primary	Code	Category/Description	State	License Number
N	204E00000X	Physicians Oral & Maxillofacial Surgery
Y	1223S0112X	Dental Providers Dentist

Other Provider Identifiers:

Issuer	Number	State	Type
	61900486	KY	05
MEDICARE GROUP	3978	KY	01
	65936221	KY	05

Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin