Organization
ROMEO N. LAUREANO, D.M.D., P.S.C.
Active
Other names
Bluegrass Oral Surgery & Dental Implant Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROMEO NANTES LAUREANO D.M.D. (OWNER/PRESIDENT)
(502) 348-1155
Entity
Organization
Contact information
Practice address
120 W STEPHEN FOSTER AVE STE 107, BARDSTOWN, KY 40004-1457
(502) 348-1155
(502) 348-3277
Mailing address
120 W STEPHEN FOSTER AVE STE 107, BARDSTOWN, KY 40004-1457
(502) 348-1155
(502) 348-3277
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000113034
BLUE CROSS
KY
05
—
60070992
—
KY
05
—
64070992
—
KY
Enumeration date
03/18/2008
Last updated
03/18/2008
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