Individual
DR. TIMOTHY M BLAIR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
500 LENTZ DR, SUITE 90 A, MADISON, TN 37115-5135
(615) 865-7176
(615) 865-5066
Mailing address
500 LENTZ DR, SUITE 90 A, MADISON, TN 37115-5135
(615) 865-7176
(615) 865-5066
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS4684
TN
1223G0001X
General Practice Dentistry
DS4684
TN
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
DS4684
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0085546
BCBS PROVIDER ID
TN
Enumeration date
10/11/2006
Last updated
09/11/2025
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