Organization
N BLANCO DDS DENTAL CORPORATION INC
Active
Other names
N Blanco DDS Dental Corporation Inc
Organization subpart
No
Provider details
NPI number
Authorized official
NUBIA A BLANCO DDS (OWNER)
(626) 919-2315
Entity
Organization
Contact information
Practice address
1431 N HACIENDA BLVD, LA PUENTE, CA 91744-1133
(626) 919-2315
(626) 919-5892
Mailing address
1431 N HACIENDA BLVD, LA PUENTE, CA 91744-1133
(626) 919-2315
(626) 919-5892
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
11/27/2019
Last updated
05/13/2020
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