Individual
DR. DANIEL MARK BLANCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
9912 CARMEL MOUNTAIN RD STE B, SAN DIEGO, CA 92129-2808
(858) 538-9182
Mailing address
4910 LONGFORD ST APT 5, SAN DIEGO, CA 92117-2159
(909) 979-7756
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
102496
CA
Other
Enumeration date
06/03/2018
Last updated
08/30/2019
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