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General NPI Number Information
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NPI Number | 1932446580
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Entity Type | Organization
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Legal Business Name | LIGIA I. BLANCO DDS INC.
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Dates
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Enumeration Date | 01/15/2013
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Last Update Date | 01/15/2013
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Provider Practice Location Address
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Address Line | 8018 STEWART AND GRAY RD
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City | DOWNEY
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State | CA
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Zip | 90241
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Country | US
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Telephone | 562-923-7799
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Fax | 562-923-3311
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Provider Business Mailing Address
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Address Line | 8018 STEWART AND GRAY RD
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City | DOWNEY
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State | CA
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Zip | 90241
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Country | US
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Telephone | 562-923-7799
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Fax | 562-923-3311
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Authorized Official
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Title or Position | CEO
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Name | MARIO SOTO
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Credential |
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Telephone | 626-419-7895
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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 | 34932
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License Number State | CA
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