Individual
DR. AMY JANE BOGARDUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
400 S 4TH ST, DANVILLE, KY 40422-2007
(859) 236-1130
(859) 239-9384
Mailing address
400 S 4TH ST, DANVILLE, KY 40422-2007
(859) 236-1130
(859) 239-9384
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
6874
KY
174400000X
Specialist
6874
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
60068749
—
KY
05
—
64026313
—
KY
Enumeration date
04/13/2006
Last updated
01/15/2014
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