Individual
DR. BLAINE TRAVIS BOHRER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1577 GENERAL BOOTH BLVD, 107, VIRGINIA BEACH, VA 23454-5105
(757) 428-8282
Mailing address
2664 LEVEL LOOP RD, VIRGINIA BEACH, VA 23456-6716
(757) 689-8809
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401410722
VA
Other
Enumeration date
02/21/2007
Last updated
07/08/2007
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