Individual
SERGIO FABIAN CALLEJA BLANCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
7611 LITTLE RIVER TPKE STE 101E, ANNANDALE, VA 22003-2630
(703) 634-4195
Mailing address
325 W LAKE LANSING RD, EAST LANSING, MI 48823-8524
(734) 353-1251
(517) 337-9759
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
2901022647
MI
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
2901022647
MI
Other
Enumeration date
06/13/2018
Last updated
04/07/2025
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