Provider Demographics
NPI:1033241724
Name:BLOIS, DEXTER (RPH)
Entity Type:Individual
Prefix:MR
First Name:DEXTER
Middle Name:
Last Name:BLOIS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 OLD NOURSE ST
Mailing Address - Street 2:
Mailing Address - City:WESTBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01581-3510
Mailing Address - Country:US
Mailing Address - Phone:508-366-5533
Mailing Address - Fax:
Practice Address - Street 1:2 OLD NOURSE ST
Practice Address - Street 2:
Practice Address - City:WESTBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01581-3510
Practice Address - Country:US
Practice Address - Phone:508-366-5533
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-09
Last Update Date:2010-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS45620183500000X
MAPH14571183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist