Individual
KENNETH A BLAIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD, MD
Contact information
Practice address
7230 HERITAGE VILLAGE PLZ STE 101, GAINESVILLE, VA 20155-3054
(703) 379-2700
Mailing address
611 S CARLIN SPRINGS RD STE 308, ARLINGTON, VA 22204-1086
(703) 379-2700
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
0401414340
VA
Other
Enumeration date
05/25/2007
Last updated
07/17/2024
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