# BLUEGRASS ORTHODONTICS PSC

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

## Provider details

- **NPI number:** 1801903554
- **Authorized official:** DR. DAVID STANFORD FERGUSON DMD MS (PARTNER)
- **Authorized official phone:** (859) 268-1190

## Contact information

- **Practice address:** 620 PERIMETER DR, \#207, LEXINGTON, KY 40517
- **Practice address phone:** (859) 268-1190
- **Practice address fax:** (859) 266-9579
- **Mailing address:** 620 PERIMETER DR, \#207, LEXINGTON, KY 40517
- **Mailing address phone:** (859) 268-1190
- **Mailing address fax:** (859) 266-9579

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 3913 | KY | — |
| 122300000X | Dentist | 5024 | KY | Yes |
| 122300000X | Dentist | 6707 | KY | — |

## Other

- **Enumeration date:** 08/25/2006
- **Last updated:** 08/22/2020