Provider Demographics
NPI:1932363918
Name:BLOOD, SHELDON TODD (DDS)
Entity Type:Individual
Prefix:DR
First Name:SHELDON
Middle Name:TODD
Last Name:BLOOD
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 1:228 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:931-762-3901
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:931-762-3901
Practice Address - Fax:931-762-3991
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-18
Last Update Date:2008-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS0088681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice