Individual
DR. BLAKE EDWARD BANDEFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
33 OVERLOOK RD STE 402, SUMMIT, NJ 07901-3564
(908) 522-0077
Mailing address
475 SHUNPIKE RD, CHATHAM, NJ 07928-1528
(301) 991-6958
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
22DI02913800
NJ
390200000X
Student in an Organized Health Care Education/Training Program
Primary
0
—
Other
Enumeration date
04/12/2019
Last updated
02/04/2026
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