Provider Demographics
NPI:1376795906
Name:NAVARRO, BLANCA E (DDS)
Entity Type:Individual
Prefix:MISS
First Name:BLANCA
Middle Name:E
Last Name:NAVARRO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 OLD FIELD RD
Mailing Address - Street 2:
Mailing Address - City:CENTERPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11721-1726
Mailing Address - Country:US
Mailing Address - Phone:917-499-8128
Mailing Address - Fax:
Practice Address - Street 1:200 OLD FIELD RD
Practice Address - Street 2:
Practice Address - City:CENTERPORT
Practice Address - State:NY
Practice Address - Zip Code:11721-1726
Practice Address - Country:US
Practice Address - Phone:917-499-8128
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-14
Last Update Date:2016-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0538901223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics