# BETO & BOGARDUS

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Danville Oral and Maxillofacial Surgery
- **Organization subpart:** No

## Provider details

- **NPI number:** 1730259292
- **Authorized official:** MRS. SHERRY L PEAVLER (OFFICE MANAGER)
- **Authorized official phone:** (859) 236-1130

## Contact information

- **Practice address:** 400 S 4TH ST, DANVILLE, KY 40422-2007
- **Practice address phone:** (859) 236-1130
- **Practice address fax:** (859) 239-9384
- **Mailing address:** 400 S 4TH ST STE 201, DANVILLE, KY 40422-2094
- **Mailing address phone:** (859) 236-1130
- **Mailing address fax:** (859) 239-9384

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | KY | Yes |
| 174400000X | Specialist | — | NULL | — |
| 174400000X | Specialist | — | — | — |

## Other

- **Enumeration date:** 11/09/2006
- **Last updated:** 02/23/2017