Individual
DR. ADAM MATTHEW BLAIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
10 N GREENE ST, BALTIMORE, MD 21201-1524
(410) 605-7056
Mailing address
6315 LORING DR, COLUMBIA, MD 21045-4483
(860) 301-7681
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
NOT LICENSED YET
MD
Other
Enumeration date
12/23/2010
Last updated
12/23/2010
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