Provider Demographics
NPI:1427178524
Name:BLUM, VALERIA G (DDS DENTIST)
Entity Type:Individual
Prefix:DR
First Name:VALERIA
Middle Name:G
Last Name:BLUM
Suffix:
Gender:F
Credentials:DDS DENTIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8100 LOMO ALTO DR
Mailing Address - Street 2:STE 240
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75225
Mailing Address - Country:US
Mailing Address - Phone:214-363-9700
Mailing Address - Fax:214-363-2987
Practice Address - Street 1:8100 LOMO ALTO DR
Practice Address - Street 2:STE 240
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75225
Practice Address - Country:US
Practice Address - Phone:214-363-9700
Practice Address - Fax:214-363-2987
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18112122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist