Provider Demographics
NPI:1376951376
Name:CALAHAN, BLAINE (DDS)
Entity Type:Individual
Prefix:DR
First Name:BLAINE
Middle Name:
Last Name:CALAHAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7703 FLOYD CURL DR
Mailing Address - Street 2:DEPARTMENT OF PERIODONTICS MSC 7894
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3901
Mailing Address - Country:US
Mailing Address - Phone:210-567-3318
Mailing Address - Fax:210-567-3393
Practice Address - Street 1:7703 FLOYD CURL DR
Practice Address - Street 2:DEPARTMENT OF PERIODONTICS MSC 7894
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3901
Practice Address - Country:US
Practice Address - Phone:210-567-3318
Practice Address - Fax:210-567-3393
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-23
Last Update Date:2014-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXETN2841223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics