Individual
ANDREA BLASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3700 NEW JERSEY AVE, WILDWOOD, NJ 08260-6154
(609) 465-0258
Mailing address
101 SEACREST LN, RIO GRANDE, NJ 08242-2837
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
22H100629100
NJ
Other
Enumeration date
04/11/2014
Last updated
04/11/2014
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