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General NPI Number Information
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NPI Number | 1114961471
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Entity Type | Individual
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Provider Name | JAMES J BLONG DDS
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Gender | Male
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Dates
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Enumeration Date | 06/16/2006
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Last Update Date | 04/24/2025
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Provider Practice Location Address
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Address Line | 3670 S 108TH ST STE 200
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City | GREENFIELD
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State | WI
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Zip | 53228-1237
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Country | US
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Telephone | 414-837-5989
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Fax | 414-837-5992
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Provider Business Mailing Address
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Address Line | 109 VIEW POINT PL
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City | WINTER SPRINGS
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State | FL
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Zip | 32708-2822
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Country | US
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Telephone | 414-881-2447
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 297915
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 2979-015
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License Number State | WI
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