Provider Demographics
NPI:1982709556
Name:BLATTER, VICTOR LANDON (DMD)
Entity Type:Individual
Prefix:DR
First Name:VICTOR
Middle Name:LANDON
Last Name:BLATTER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7940 S UNIVERSITY BLVD
Mailing Address - Street 2:STE. 200
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80122-5104
Mailing Address - Country:US
Mailing Address - Phone:720-482-0793
Mailing Address - Fax:720-482-0796
Practice Address - Street 1:7940 S UNIVERSITY BLVD
Practice Address - Street 2:STE. 200
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80122-5104
Practice Address - Country:US
Practice Address - Phone:720-482-0793
Practice Address - Fax:720-482-0796
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO87941223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice