| Bluegrass Family Dentistry, Pllc | |
|
1317 N Main St Beaver Dam KY 42320-8957 | |
| (270) 775-6063 | |
| (270) 775-6123 |
| Full Name | Bluegrass Family Dentistry, Pllc |
|---|---|
| Speciality | Dentist |
| Location | 1317 N Main St, Beaver Dam, Kentucky |
| Authorized Official Name and Position | Kelsey Diane Johnson (OWNER/MEMBER) |
| Authorized Official Contact | 2702563967 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bluegrass Family Dentistry, Pllc Po Box 535 Beaver Dam KY 42320-0535 Ph: (270) 775-6063 | Bluegrass Family Dentistry, Pllc 1317 N Main St Beaver Dam KY 42320-8957 Ph: (270) 775-6063 |
| NPI Number | 1093241796 |
|---|---|
| Provider Enumeration Date | 05/02/2017 |
| Last Update Date | 05/02/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093241796 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 9595 (Kentucky) | Primary |
News Archive
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› Verified 3 days ago
Ohio County Family Dentistry Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1221 N Main St, Beaver Dam, KY 42320 Phone: 270-274-3379 Fax: 270-274-4600 |