Individual
MRS. MARIA A BLAZEK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
21111 NORTHERN BLVD FL 2, BAYSIDE, NY 11361-3241
(718) 224-2094
Mailing address
10 PASTURE ROAD, KINGS PARK, NY 11754
(631) 269-1021
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
010438-1
NY
Other
Enumeration date
09/07/2007
Last updated
09/07/2007
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