Individual
DR. GONZALO BLASI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS MS
Contact information
Practice address
305 W FAYETTE ST APT 1412, BALTIMORE, MD 21201-3466
(443) 980-8835
Mailing address
305 W FAYETTE ST APT 1412, BALTIMORE, MD 21201-3466
(443) 980-8835
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
0401415436
VA
Other
Enumeration date
02/26/2017
Last updated
02/26/2017
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