Provider Demographics
NPI:1497715510
Name:BLANN, LINDA S (DDS)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:S
Last Name:BLANN
Suffix:
Gender:F
Credentials:DDS
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Mailing Address - Street 1:250 FAME AVE
Mailing Address - Street 2:SUITE 206
Mailing Address - City:HANOVER
Mailing Address - State:PA
Mailing Address - Zip Code:17331-1587
Mailing Address - Country:US
Mailing Address - Phone:717-637-0202
Mailing Address - Fax:717-637-5855
Practice Address - Street 1:250 FAME AVE
Practice Address - Street 2:SUITE 206
Practice Address - City:HANOVER
Practice Address - State:PA
Practice Address - Zip Code:17331-1587
Practice Address - Country:US
Practice Address - Phone:717-637-7775
Practice Address - Fax:717-637-5855
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2013-12-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PA281161223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1395776004Medicaid