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General NPI Number Information
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NPI Number | 1972819506
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Entity Type | Individual
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Provider Name | BRITTANY P BLUE DDS
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Gender | Female
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Dates
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Enumeration Date | 08/20/2010
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Last Update Date | 07/02/2018
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Provider Practice Location Address
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Address Line | 1115 W FRIENDLY AVE
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City | GREENSBORO
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State | NC
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Zip | 27401
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Country | US
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Telephone | 336-272-4595
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Fax |
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Provider Business Mailing Address
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Address Line | 1806 MADISON AVE
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City | GREENSBORO
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State | NC
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Zip | 27403-1706
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Country | US
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Telephone | 704-560-6191
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 04425000127
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 8962
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License Number State | NC
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