Healthcare Provider Details
I. General information
NPI: 1316163710
Provider Name (Legal Business Name): BLANCA PATRICIA ROJAS DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/17/2007
Last Update Date: 11/13/2020
Certification Date: 11/13/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1881 N UNIVERSITY DR STE 208
CORAL SPRINGS FL
33071-6098
US
IV. Provider business mailing address
1881 N UNIVERSITY DR STE 208
CORAL SPRINGS FL
33071-6098
US
V. Phone/Fax
- Phone: 954-393-0303
- Fax: 954-393-0118
- Phone: 954-393-0303
- Fax: 954-393-0118
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223X0400X |
| Taxonomy | Orthodontics and Dentofacial Orthopedics Dentistry |
| License Number | DN16107 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: