Provider Demographics
NPI:1639263437
Name:BLANEK, HARRY J (DDS, MS)
Entity Type:Individual
Prefix:
First Name:HARRY
Middle Name:J
Last Name:BLANEK
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2811 CLIFFSIDE DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75227-6715
Mailing Address - Country:US
Mailing Address - Phone:214-381-6224
Mailing Address - Fax:
Practice Address - Street 1:3501 SHEPHERD LN
Practice Address - Street 2:
Practice Address - City:BALCH SPRINGS
Practice Address - State:TX
Practice Address - Zip Code:75180-2325
Practice Address - Country:US
Practice Address - Phone:972-286-5711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7005122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist