# BLUEGRASS DENTAL, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1194235176
- **Authorized official:** DR. SHAUN MICHAEL BIVENS DMD (OWNER)
- **Authorized official phone:** (615) 974-2956

## Contact information

- **Practice address:** 1302 DOW ST, MURFREESBORO, TN 37130-2414
- **Practice address phone:** (615) 896-4860
- **Mailing address:** 600 GEORGETOWN DR, NASHVILLE, TN 37205-2622
- **Mailing address phone:** (615) 974-2956

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 8528 | TN | Yes |

## Other

- **Enumeration date:** 10/04/2017
- **Last updated:** 10/04/2017