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DR. THOMAS JOHN BLUE DMD

General Practice >> Dentist >> Dental Providers

Registrant NPI Number: 1518075530

Individual Registrant:
DR. THOMAS JOHN BLUE DMD
Gender: M
Not Sole Proprietor

Location and contact information for practice:
575 S WICKHAM RD STE D  WEST MELBOURNE, FL 32904-1170 US
Tel: 321-768-0991  Fax: 321-727-7909

Contact information for business:
575 S WICKHAM RD STE D  WEST MELBOURNE, FL 32904-1170 US
Tel: 321-768-0991  Fax: 321-727-7909

Registration Information:
NPI: 1518075530
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y1223G0001XDental Providers
Dentist
General Practice
FLDN9554

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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