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General NPI Number Information
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NPI Number | 1720394935
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Entity Type | Organization
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Legal Business Name | CARLEN PALMER BLUME DDS, PC
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Dates
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Enumeration Date | 08/25/2010
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Last Update Date | 06/19/2019
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Provider Practice Location Address
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Address Line | 8366 N LOOP 1604 W STE 108
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City | SAN ANTONIO
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State | TX
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Zip | 78249-3533
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Country | US
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Telephone | 210-614-3334
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Fax | 210-614-3331
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Provider Business Mailing Address
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Address Line | 8366 N LOOP 1604 W STE 108
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City | SAN ANTONIO
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State | TX
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Zip | 78249-3533
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Country | US
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Telephone | 210-614-3334
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Fax | 210-614-3331
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Authorized Official
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Title or Position | DENTIST
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Name | DR. CARLEN BLUME
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Credential | DDS
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Telephone | 210-614-3334
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 20057
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License Number State | TX
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