Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | DN16134 | FL |
NPI | 1104911015 |
---|---|
Provider Name | Dr. Giancarlo Bland |
First Address | Boca Raton, FL 33431-7202 |
Second Address | Boca Raton, FL 33431-7202 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2006 |
Last Update Date | 07/10/2009 |