| Danville Oral And Maxillofacial Surgery | |
|
400 S 4th St Danville KY 40422-2007 | |
| (859) 236-1130 | |
| (859) 239-9384 |
| Full Name | Danville Oral And Maxillofacial Surgery |
|---|---|
| Speciality | Dentist |
| Location | 400 S 4th St, Danville, Kentucky |
| Authorized Official Name and Position | Sherry L Peavler (OFFICE MANAGER) |
| Authorized Official Contact | 8592361130 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Danville Oral And Maxillofacial Surgery 400 S 4th St Ste 201 Danville KY 40422-2094 Ph: (859) 236-1130 | Danville Oral And Maxillofacial Surgery 400 S 4th St Danville KY 40422-2007 Ph: (859) 236-1130 |
| NPI Number | 1730259292 |
|---|---|
| Provider Enumeration Date | 11/09/2006 |
| Last Update Date | 02/23/2017 |
| Medicare PECOS PAC ID | 5799757514 |
|---|---|
| Medicare Enrollment ID | O20040811000602 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730259292 | NPI | - | NPPES |
| 64031842 | Medicaid | KY | |
| 61941860 | Medicaid | KY | |
| 65912990 | Medicaid | KY | |
| 60003175 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (Kentucky) | Primary |
| 174400000X | Specialist | (* (Not Available)) | Secondary |
| Provider Name | Louis Beto |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1114981420 PECOS PAC ID: 5597737312 Enrollment ID: I20120524000531 |
| Provider Name | Amy Jane Bogardus |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1558325878 PECOS PAC ID: 5991972127 Enrollment ID: I20120524000553 |
| Provider Name | Justin R Kolasa |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1598100372 PECOS PAC ID: 1557697794 Enrollment ID: I20190725003816 |
Danville Peds Dre Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1080 Ben Ali Dr Ste A, Danville, KY 40422 Phone: 859-236-6900 | |
Robert Taylor Dmd, Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 435 Whirlaway Dr, Danville, KY 40422 Phone: 859-236-4304 | |
Bostick Dental Center Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 122 Daniel Dr, Danville, KY 40422 Phone: 859-236-1810 Fax: 859-236-1802 | |
Susan H. Couzens Dmd Psc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 400 S 4th St, Suite 101, Danville, KY 40422 Phone: 859-236-4304 | |
Webster Orthodontics Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 359 S 4th St Ste B, Danville, KY 40422 Phone: 859-236-1912 Fax: 859-236-4589 | |
Boyd Family Dentistry Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 151 N 3rd St, Suite 2, Danville, KY 40422 Phone: 859-236-8229 | |
Chris Bostick, Dmd,pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 129 Daniel Dr, Danville, KY 40422 Phone: 859-236-1810 Fax: 859-236-1802 |