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General NPI Number Information
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NPI Number | 1275057150
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Entity Type | Individual
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Provider Name | CARMEN BLUNT DDS
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Gender | Female
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Dates
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Enumeration Date | 08/01/2017
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Last Update Date | 08/01/2017
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Provider Practice Location Address
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Address Line | 4431 W WALNUT ST STE A
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City | GARLAND
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State | TX
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Zip | 75042-4108
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Country | US
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Telephone | 972-485-1200
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Fax |
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Provider Business Mailing Address
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Address Line | 11825 CONANT LN
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City | FRISCO
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State | TX
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Zip | 75035-8102
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Country | US
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Telephone | 501-681-6419
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Fax | 501-681-6419
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 33429
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License Number State | TX
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