Individual
THOMAS BLAKE HIGGINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
105 EDWARDS VILLAGE BLVD SUITE D-202, PO BOX 41, EDWARDS, CO 81632
(970) 926-8486
Mailing address
400 S LAFAYETTE ST APT 607, DENVER, CO 80209-2598
(970) 390-4662
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
00203482
CO
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
05/08/2015
Last updated
07/16/2024
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