# BLUEGRASS DENTISTRY

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

## Provider details

- **NPI number:** 1518131796
- **Authorized official:** NARDOS A BENTON DMD (OWNER)
- **Authorized official phone:** (859) 543-0505

## Contact information

- **Practice address:** 3475 RICHMOND RD, SUITE 100, LEXINGTON, KY 40509-2500
- **Practice address phone:** (859) 543-0505
- **Mailing address:** 3475 RICHMOND RD, SUITE 100, LEXINGTON, KY 40509-2500
- **Mailing address phone:** (859) 543-0505

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 7756 | KY | Yes |

## Other

- **Enumeration date:** 04/17/2008
- **Last updated:** 04/17/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 45003365 | — | KY |
| 05 | — | 60000981 | — | KY |