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Organization
BETO & BOGARDUS
Active
Organization
BETO & BOGARDUS
Active
Other names
Danville Oral and Maxillofacial Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHERRY L PEAVLER (OFFICE MANAGER)
(859) 236-1130
Entity
Organization
Contact information
Practice address
400 S 4TH ST, DANVILLE, KY 40422-2007
(859) 236-1130
(859) 239-9384
Mailing address
400 S 4TH ST STE 201, DANVILLE, KY 40422-2094
(859) 236-1130
(859) 239-9384
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
KY
174400000X
Specialist
—
NULL
174400000X
Specialist
—
—
Other
Enumeration date
11/09/2006
Last updated
02/23/2017
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