Individual
DR. JESSE BLAIR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2121 E DUPONT RD STE A, FORT WAYNE, IN 46825-1546
(843) 281-0182
Mailing address
2121 E DUPONT RD STE A, FORT WAYNE, IN 46825-1546
(260) 490-9684
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12013093A
IN
Other
Enumeration date
08/22/2016
Last updated
03/25/2021
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