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General NPI Number Information
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NPI Number | 1265578413
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Entity Type | Organization
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Legal Business Name | BLUHM, DORSCH AND VANDERVORT, PC
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Dates
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Enumeration Date | 01/29/2007
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Last Update Date | 01/25/2022
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Provider Practice Location Address
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Address Line | 44340 PREMIER PLZ SUITE 100
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City | ASHBURN
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State | VA
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Zip | 20147-5025
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Country | US
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Telephone | 703-729-8700
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Fax | 703-729-5300
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Provider Business Mailing Address
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Address Line | 44340 PREMIER PLZ SUITE 100
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City | ASHBURN
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State | VA
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Zip | 20147-5073
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Country | US
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Telephone | 703-729-8700
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Fax | 703-729-5300
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ANDREW EDWARD BLUHM
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Credential | D.D.S
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Telephone | 703-729-8700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 0401007764
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number |
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License Number State |
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