Provider Demographics
NPI:1457661175
Name:SHELDON T. BLOOD, D.D.S.,P.C.
Entity Type:Organization
Organization Name:SHELDON T. BLOOD, D.D.S.,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHELDON
Authorized Official - Middle Name:TODD
Authorized Official - Last Name:BLOOD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS,PC
Authorized Official - Phone:931-762-3991
Mailing Address - Street 1:228 PULASKI ST
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEBURG
Mailing Address - State:TN
Mailing Address - Zip Code:38464-3312
Mailing Address - Country:US
Mailing Address - Phone:931-762-3991
Mailing Address - Fax:931-762-3991
Practice Address - Street 1:228 PULASKI ST
Practice Address - Street 2:
Practice Address - City:LAWRENCEBURG
Practice Address - State:TN
Practice Address - Zip Code:38464-3312
Practice Address - Country:US
Practice Address - Phone:931-762-3991
Practice Address - Fax:931-762-3991
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-15
Last Update Date:2010-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN8868122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty