Provider Demographics
NPI:1972819506
Name:BLUE, BRITTANY P (DDS)
Entity Type:Individual
Prefix:DR
First Name:BRITTANY
Middle Name:P
Last Name:BLUE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:BRITTANY
Other - Middle Name:P
Other - Last Name:SEMONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:1806 MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27403-1706
Mailing Address - Country:US
Mailing Address - Phone:704-560-6191
Mailing Address - Fax:
Practice Address - Street 1:1115 W FRIENDLY AVE
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401
Practice Address - Country:US
Practice Address - Phone:336-272-4595
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-20
Last Update Date:2018-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA044250001271223G0001X
NC89621223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice