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Individual

DR. MICHAEL ANTHONY BLASEK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.M.D.

Contact information

Practice address
520 LIMEKILN PIKE, MAPLE GLEN, PA 19002-2901
(215) 643-0666
Mailing address
520 LIMEKILN PIKE, MAPLE GLEN, PA 19002-2901
(215) 643-0666

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS-024133-L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
DS-024133-L
LICENSE NUMBER
PA
Enumeration date
02/22/2007
Last updated
07/08/2007
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