Individual
IVETTE BLANCO-PADILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
8999 AIRBORNE DIVISION RD, BLDG 3255, FORT BENNING, GA 31905
(706) 544-9170
Mailing address
5462 WHITTLESEY BLVD APT 212, COLUMBUS, GA 31909-2199
(910) 568-9561
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2414
PR
1223G0001X
General Practice Dentistry
2414
PR
Other
Enumeration date
03/07/2007
Last updated
03/13/2023
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