Individual
MRS. TYE SPADY BLAIR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH, PHDHP
Contact information
Practice address
5201 HAVERFORD AVE, PHILADELPHIA, PA 19139-1401
(215) 471-2761
Mailing address
5201 HAVERFORD AVE, PHILADELPHIA, PA 19139-1401
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
PHDH001026
PA
Other
Enumeration date
08/24/2020
Last updated
08/24/2020
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