Provider Demographics
NPI:1932233301
Name:SUAREZ, BLANCHE MARIE (DDS)
Entity Type:Individual
Prefix:DR
First Name:BLANCHE
Middle Name:MARIE
Last Name:SUAREZ
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 BRIDLE WAY
Mailing Address - Street 2:
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-1237
Mailing Address - Country:US
Mailing Address - Phone:201-226-9200
Mailing Address - Fax:201-226-9288
Practice Address - Street 1:5 BRIDLE WAY
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-1237
Practice Address - Country:US
Practice Address - Phone:201-226-9200
Practice Address - Fax:201-226-9288
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
NJDIO186031223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ013921NJDOtherPROVIDER ID