Individual
DR. THEODORE A. BLANEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D. M. D.
Contact information
Practice address
1118 PROFESSIONAL DR # A, WILLIAMSBURG, VA 23185-3330
(757) 229-5570
(757) 259-0719
Mailing address
1118 PROFESSIONAL DR # A, WILLIAMSBURG, VA 23185-3330
(757) 229-5570
(757) 259-0719
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401006463
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000000235147
ANTHEM
VA
01
—
763008
UNITED CONCORDIA INS.
VA
Enumeration date
10/03/2006
Last updated
07/08/2007
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