Provider Demographics
NPI:1720468903
Name:EMILY BLAND DDS INC
Entity Type:Organization
Organization Name:EMILY BLAND DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:
Authorized Official - Last Name:BLAND
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:619-370-1995
Mailing Address - Street 1:6080 LAKE MURRAY BLVD., SUITE B
Mailing Address - Street 2:
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91942
Mailing Address - Country:US
Mailing Address - Phone:619-460-0911
Mailing Address - Fax:
Practice Address - Street 1:6080 LAKE MURRAY BLVD.
Practice Address - Street 2:
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942
Practice Address - Country:US
Practice Address - Phone:619-460-0911
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-03
Last Update Date:2015-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA50547122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty