Individual
DR. CARLA M BLAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
229 POST AVE, WESTBURY, NY 11590-3021
(516) 282-5100
Mailing address
1311 JACKSON AVE, APT 10D, LONG ISLAND CITY, NY 11101-5436
(516) 425-3076
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
050759
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02420088
—
NY
Enumeration date
10/14/2005
Last updated
04/09/2008
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