Individual
MR. DAVID BLANCO
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Contact information
Practice address
557 BROAD ST, PROVIDENCE, RI 02907-1403
(401) 444-0430
(401) 444-0489
Mailing address
375 ALLENS AVE, PROVIDENCE, RI 02905-5010
(401) 444-0400
(401) 444-0468
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DEN02863
RI
Other
Enumeration date
08/31/2005
Last updated
07/08/2007
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