| Blanco Jamis Dental Group, P.a. | |
|
5701 Sw 107th Ave Ste 101 Miami FL 33173-1276 | |
| (305) 262-4604 | |
| (305) 239-8999 |
| Full Name | Blanco Jamis Dental Group, P.a. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 5701 Sw 107th Ave Ste 101, Miami, Florida |
| Authorized Official Name and Position | Jorge L Blanco (PRESIDENT) |
| Authorized Official Contact | 3052624604 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Blanco Jamis Dental Group, P.a. Po Box 440308 Miami FL 33144-0308 Ph: (305) 262-4604 | Blanco Jamis Dental Group, P.a. 5701 Sw 107th Ave Ste 101 Miami FL 33173-1276 Ph: (305) 262-4604 |
| NPI Number | 1265780704 |
|---|---|
| Provider Enumeration Date | 08/15/2012 |
| Last Update Date | 11/17/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265780704 | NPI | - | NPPES |
| 1609046960 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DN 16115 (Florida) | Primary |
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