NPI 1710679105 · live from the CMS NPI Registry
Bluegrass Dental Anesthesia, LLC
Dentist, Dentist Anesthesiologist Speciality in Louisville, KY. National Provider Identifier 1710679105, active.
NPI record
| NPI | 1710679105 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Dentist, Dentist Anesthesiologist Speciality 1223D0004X |
| Practice location | 3001 Hayfield Dr, Louisville, KY 40205 |
| Practice phone | 408-314-4968 |
| Enumerated | May 23, 2023 |
| Last updated | May 23, 2023 |
| Authorized official | David Guthrie, Manager/ Dentist Anesthesiologist |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Anesthesiology | 207L00000X | — |
| Dentist, Dentist Anesthesiologist Speciality primary | 1223D0004X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.