| Bluegrass Dentistry | |
|
3475 Richmond Rd Suite 100 Lexington KY 40509-2500 | |
| (859) 543-0505 | |
| Not Available |
| Full Name | Bluegrass Dentistry |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 3475 Richmond Rd, Lexington, Kentucky |
| Authorized Official Name and Position | Nardos A Benton (OWNER) |
| Authorized Official Contact | 8595430505 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bluegrass Dentistry 3475 Richmond Rd Suite 100 Lexington KY 40509-2500 Ph: (859) 543-0505 | Bluegrass Dentistry 3475 Richmond Rd Suite 100 Lexington KY 40509-2500 Ph: (859) 543-0505 |
| NPI Number | 1518131796 |
|---|---|
| Provider Enumeration Date | 04/17/2008 |
| Last Update Date | 04/17/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518131796 | NPI | - | NPPES |
| 60000981 | Medicaid | KY | |
| 45003365 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 7756 (Kentucky) | Primary |
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