Organization
BLUEGRASS DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NARDOS A BENTON DMD (OWNER)
(859) 543-0505
Entity
Organization
Contact information
Practice address
3475 RICHMOND RD, SUITE 100, LEXINGTON, KY 40509-2500
(859) 543-0505
Mailing address
3475 RICHMOND RD, SUITE 100, LEXINGTON, KY 40509-2500
(859) 543-0505
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7756
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
45003365
—
KY
05
—
60000981
—
KY
Enumeration date
04/17/2008
Last updated
04/17/2008
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