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General NPI Number Information
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NPI Number | 1689032526
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Entity Type | Individual
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Provider Name | BLAIRE STONE
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Gender | Female
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Dates
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Enumeration Date | 02/07/2016
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Last Update Date | 02/07/2016
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Provider Practice Location Address
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Address Line | 1828 W LAKE AVE DENTISTRY 2ND FLOOR
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City | NEPTUNE
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State | NJ
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Zip | 07753-4663
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Country | US
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Telephone | 908-814-2324
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Fax |
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Provider Business Mailing Address
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Address Line | 39 COVE DR
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City | BAYVILLE
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State | NJ
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Zip | 08721-1076
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Country | US
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Telephone |
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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 | 22DI02626100
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License Number State | NJ
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