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General NPI Number Information
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NPI Number | 1841434461
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Entity Type | Individual
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Provider Name | DANIEL S BLUE D.D.S., M.S.
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Gender | Male
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Dates
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Enumeration Date | 04/27/2009
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Last Update Date | 11/19/2014
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Provider Practice Location Address
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Address Line | 224 WEST SAN JUAN AVENUE
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City | PHOENIX
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State | AZ
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Zip | 85013
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Country | US
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Telephone | 602-677-5339
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Fax |
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Provider Business Mailing Address
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Address Line | 4921 E BELL RD STE 201
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City | SCOTTSDALE
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State | AZ
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Zip | 85254-6002
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Country | US
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Telephone | 602-677-5339
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | D5378
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License Number State | AZ
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