| Thomas J And Effie K Blue, Dmd, Pa | |
|
575 S Wickham Rd Suite D W Melbourne FL 32904-1170 | |
| (321) 768-0991 | |
| (321) 727-7909 |
| Full Name | Thomas J And Effie K Blue, Dmd, Pa |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 575 S Wickham Rd, W Melbourne, Florida |
| Authorized Official Name and Position | Thomas J Blue (OWNER/DENTIST) |
| Authorized Official Contact | 3217680991 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Thomas J And Effie K Blue, Dmd, Pa 575 S Wickham Rd Suite D W Melbourne FL 32904-1170 Ph: (321) 768-0991 | Thomas J And Effie K Blue, Dmd, Pa 575 S Wickham Rd Suite D W Melbourne FL 32904-1170 Ph: (321) 768-0991 |
| NPI Number | 1194124339 |
|---|---|
| Provider Enumeration Date | 08/13/2014 |
| Last Update Date | 08/13/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194124339 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DN9554 (Florida) | Primary |