Provider Demographics
NPI:1639532542
Name:BLUMENKRANZ SANCHEZ, GABRIEL (DDS, CAGS, MSC)
Entity Type:Individual
Prefix:DR
First Name:GABRIEL
Middle Name:
Last Name:BLUMENKRANZ SANCHEZ
Suffix:
Gender:M
Credentials:DDS, CAGS, MSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1575 E 13 MILE RD
Mailing Address - Street 2:APT. 107
Mailing Address - City:MADISON HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48071-5012
Mailing Address - Country:US
Mailing Address - Phone:301-310-3167
Mailing Address - Fax:
Practice Address - Street 1:1575 E 13 MILE RD
Practice Address - Street 2:APT. 107
Practice Address - City:MADISON HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48071-5012
Practice Address - Country:US
Practice Address - Phone:301-310-3167
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-30
Last Update Date:2016-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE60436640122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist