Individual
DR. JASON BRIAN BLUNDELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
410 W BLOOMINGDALE AVE, BRANDON, FL 33511-7402
(813) 531-9116
Mailing address
2541 WHITTLER BR, ODESSA, FL 33556-1875
(804) 683-1562
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
0401412191
VA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
0401412191
VA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
23175
FL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DN23175
FL
Other
Enumeration date
06/27/2008
Last updated
06/14/2022
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