Organization
DIANA BLANCO DMD PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANA BLANCO DMD (DENTIST)
(305) 456-4592
Entity
Organization
Contact information
Practice address
279 NW 82ND AVE, MIAMI, FL 33126-8339
(305) 456-4592
(786) 360-6953
Mailing address
279 NW 82ND AVE, MIAMI, FL 33126-8339
(305) 456-4592
(786) 360-6953
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
1223E0200X
Endodontics
—
—
1223G0001X
General Practice Dentistry
Primary
—
—
1223P0300X
Periodontics
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
Other
Enumeration date
02/20/2025
Last updated
02/20/2025
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