Provider Demographics
NPI:1922019009
Name:SOTOMAYOR, BLANCA STELLA (DMD)
Entity Type:Individual
Prefix:DR
First Name:BLANCA
Middle Name:STELLA
Last Name:SOTOMAYOR
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 NOTTINGHAM WAY
Mailing Address - Street 2:
Mailing Address - City:STONEHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02180
Mailing Address - Country:US
Mailing Address - Phone:781-279-2702
Mailing Address - Fax:781-279-2702
Practice Address - Street 1:BAY 237
Practice Address - Street 2:LEWIS WHARF DENTAL ASSOCIATES
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02110
Practice Address - Country:US
Practice Address - Phone:617-227-4831
Practice Address - Fax:617-227-3174
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA174921223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics