Organization
BLUEGRASS DENTAL, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHAUN MICHAEL BIVENS DMD (OWNER)
(615) 974-2956
Entity
Organization
Contact information
Practice address
1302 DOW ST, MURFREESBORO, TN 37130-2414
(615) 896-4860
Mailing address
600 GEORGETOWN DR, NASHVILLE, TN 37205-2622
(615) 974-2956
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8528
TN
Other
Enumeration date
10/04/2017
Last updated
10/04/2017
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