Organization
BLUEGRASS ORAL & MAXILLOFACIAL SURGERY PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM J BARKER DMD (PRESIDENT)
(859) 278-5377
Entity
Organization
Contact information
Practice address
1401 HARRODSBURG ROAD, SUITE B395, LEXINGTON, KY 40504
(859) 278-5377
(859) 278-0903
Mailing address
1401 HARRODSBURG ROAD, SUITE B395, LEXINGTON, KY 40504
(859) 278-5377
(859) 278-0903
Taxonomy
Speciality
Code
Description
License number
State
1223P0106X
Oral and Maxillofacial Pathology Dentistry
6088
KY
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
6088
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
61900734
MEDICAID DENTAL
—
01
—
65939365
MEDICAL
—
Enumeration date
08/25/2006
Last updated
09/11/2025
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