Provider Demographics
NPI:1891947909
Name:BLANCHI, THOMAS CEDRIC (DDS)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:CEDRIC
Last Name:BLANCHI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 DEVONSHIRE PL
Mailing Address - Street 2:APT 2710
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02109-3510
Mailing Address - Country:US
Mailing Address - Phone:617-834-8827
Mailing Address - Fax:
Practice Address - Street 1:1 KNEELAND ST
Practice Address - Street 2:DEPARTEMENT OF PERIODONTOLOGY
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02111-1527
Practice Address - Country:US
Practice Address - Phone:617-636-6531
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-21
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA104531223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics