James Mickael Blaney, DDS, MSD

Individual provider Active NPI Endodontics · Goodlettsville, TN

NPI 1003889874 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1003889874
Entity type
Individual (NPI type 1)
Primary specialty
Endodontics 1223E0200X
License
DS0000007949 (TN)
Practice address
306 Bluebird Dr
Goodlettsville, TN 37072-2304
Phone
(615) 851-9111
Fax
(615) 851-1608
NPI assigned
Feb 10, 2006
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
DS0000007949TNMDEndodontist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X DS0000007949 TN Yes

Addresses

Primary practice location

306 Bluebird Dr
Goodlettsville, TN 37072-2304

Mailing address

306 Bluebird Dr
Goodlettsville, TN 37072-2304
Phone (615) 851-9111

Other providers in Goodlettsville, TN

All providers in Goodlettsville, TN · Endodontics in Tennessee

Sources for this page

Verify at the official NPI Registry.