Provider Demographics
NPI:1528192929
Name:BLAIR, DENNIS A (DDS)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:A
Last Name:BLAIR
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 1:6548 E QUAKER ST
Mailing Address - Street 2:
Mailing Address - City:ORCHARD PARK
Mailing Address - State:NY
Mailing Address - Zip Code:14127-2502
Mailing Address - Country:US
Mailing Address - Phone:716-662-3232
Mailing Address - Fax:716-662-7545
Practice Address - Street 1:6548 E QUAKER ST
Practice Address - Street 2:
Practice Address - City:ORCHARD PARK
Practice Address - State:NY
Practice Address - Zip Code:14127-2502
Practice Address - Country:US
Practice Address - Phone:716-662-3232
Practice Address - Fax:716-662-7545
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY032915-11223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice