Individual
JOSEPH H BLUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
8215 ROOSEVELT AVE, JACKSON HEIGHTS, NY 11372-7034
(718) 205-7709
(718) 205-7718
Mailing address
7131 LOUBET ST, FOREST HILLS, NY 11375-6720
(718) 575-0524
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
048797
NY
1223G0001X
General Practice Dentistry
DI02125300
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02842120
—
NY
Enumeration date
05/20/2007
Last updated
07/08/2007
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