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NPI Code Detail

MEDICARE: DR. GARY JOSEPH BLANCHETTE DDS

MEDICARE:  DR. GARY JOSEPH BLANCHETTE  DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry3929LA

General Provider Information

NPI Number : 1427107887
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GARY JOSEPH BLANCHETTE DDS
Provider Business Mailing Address
First Line : 2920 MAPLEWOOD DR
Second Line :
City : SULPHUR
State : LA
Zip : 70663-6114
Country : US
Telephone Number : 337-625-8532
Fax Number : 337-625-4876
Provider Business Practice Location Address
First Line : 2920 MAPLEWOOD DR
Second Line :
City : SULPHUR
State : LA
Zip : 70663-6114
Country : US
Telephone Number : 337-625-8532
Fax Number : 337-625-4876
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/08/2007
Last Update Date : 07/08/2007

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Directions to “ DR. GARY JOSEPH BLANCHETTE DDS” Practice Location

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