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Organization
CHARLES A. BLUMLE D.D.S., P.C.
Active
Organization
CHARLES A. BLUMLE D.D.S., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES A. BLUMLE D.D.S. (PRESIDENT)
(814) 486-0650
Entity
Organization
Contact information
Practice address
404 N MAPLE ST, EMPORIUM, PA 15834-1225
(814) 486-0650
Mailing address
404 N MAPLE ST, EMPORIUM, PA 15834-1225
(814) 486-0650
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS-019669-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0005281700001
ACCESS
PA
01
—
73459
UNITED CONCORDIA
—
Enumeration date
07/18/2007
Last updated
07/18/2007
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