Healthcare Provider Details

I. General information

NPI: 1710964028
Provider Name (Legal Business Name): CHRISTOPHER ANDREW BLOUNT DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/28/2005
Last Update Date: 12/27/2023
Certification Date: 12/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

285 HIGH ST
GREENFIELD MA
01301-2608
US

IV. Provider business mailing address

285 HIGH ST
GREENFIELD MA
01301-2608
US

V. Phone/Fax

Practice location:
  • Phone: 413-774-2961
  • Fax: 413-773-3076
Mailing address:
  • Phone: 413-774-2961
  • Fax: 413-773-3076

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204E00000X
TaxonomyOral & Maxillofacial Surgery (D.M.D.)
License Number1855672
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number1855672
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code204E00000X
TaxonomyOral & Maxillofacial Surgery (D.M.D.)
License Number04127
License Number StateNH
# 4
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number0160066233
License Number StateVT
# 5
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number04127
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: