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DR. TEDDY ROGER BLAND DMD, MS
>> Dentist >> Dental ProvidersRegistrant NPI Number: 1003008723
Individual Registrant:DR. TEDDY ROGER BLAND DMD, MS
Gender: M
Sole Proprietor
Gender: M
Sole Proprietor
Location and contact information for practice:
1340 E ORANGE AVE EUSTIS, FL 32726-4343 US
Tel: 352-735-2005 Fax: --
Tel: 352-735-2005 Fax: --
Contact information for business:
1340 E ORANGE AVE EUSTIS, FL 32726-4343 US
Tel: 352-735-2005 Fax: --
Tel: 352-735-2005 Fax: --
Registration Information:
NPI: 1003008723
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 122300000X | Dental Providers Dentist | FL | DN 17164 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
