# BURT & JACKSON DMD PLLC BLUEGRASS ORAL HEALTH CENTER OF MORGANTOWN

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Bluegrass Oral Health Center Of Morgantown
- **Organization subpart:** No

## Provider details

- **NPI number:** 1750555033
- **Authorized official:** DR. ANDREW MADISON BURT D.M.D. (DR./OWNER)
- **Authorized official phone:** (270) 526-3346

## Contact information

- **Practice address:** 304 WEST OHIO ST., MORGANTOWN, KY 42261
- **Practice address phone:** (270) 526-3346
- **Practice address fax:** (270) 781-6129
- **Mailing address:** 304 WEST OHIO ST., MORGANTOWN, KY 42261
- **Mailing address phone:** (270) 526-3346

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 7273 | KY | Yes |

## Other

- **Enumeration date:** 04/17/2008
- **Last updated:** 06/17/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | PENDING | — | KY |