Organization
BLUEGRASS PEDIATRIC DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY LUCAS BOWEN D.M.D. (DENTIST)
(859) 626-1810
Entity
Organization
Contact information
Practice address
120 MERIDIAN WAY, SUITE 2, RICHMOND, KY 40475
(859) 626-1810
Mailing address
120 MERIDIAN WAY, SUITE # 2, RICHMOND, KY 40475
(859) 626-1810
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
09/03/2010
Last updated
06/16/2016
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