| NPI | 1750552733 |
|---|---|
| Doing Business As | BLUEGRASS ORAL SURGERY & DENTAL IMPLANT CENTER |
| Entity Type | Organization |
| Authorized Contact | ROMEO NANTES LAUREANO Owner/President 502-348-1155 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 204E00000X Oral & Maxillofacial Surgery |
| Enumeration Date | 2008-03-18 |
| Last Update Date | 2008-03-18 |