| Bluegrass Peds Dre Llc | |
|
120 Meridian Way Ste 2 Richmond KY 40475-2881 | |
| (859) 626-1810 | |
| Not Available |
| Full Name | Bluegrass Peds Dre Llc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 120 Meridian Way Ste 2, Richmond, Kentucky |
| Authorized Official Name and Position | Elizabeth Davis (DIRECTOR OF REVENUE) |
| Authorized Official Contact | 8595331109 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bluegrass Peds Dre Llc 105 Spruce St Lexington KY 40507-2109 Ph: () - | Bluegrass Peds Dre Llc 120 Meridian Way Ste 2 Richmond KY 40475-2881 Ph: (859) 626-1810 |
| NPI Number | 1467227835 |
|---|---|
| Provider Enumeration Date | 11/16/2023 |
| Last Update Date | 11/16/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467227835 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
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