Provider Demographics
NPI:1093841553
Name:E NORMAND BLANCHETTE DDS PC
Entity type:Organization
Organization Name:E NORMAND BLANCHETTE DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EDMOND
Authorized Official - Middle Name:NORMAND
Authorized Official - Last Name:BLANCHETTE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:602-242-3284
Mailing Address - Street 1:2200 WEST BETHANY HOME RD
Mailing Address - Street 2:SUITE 10
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85015-1937
Mailing Address - Country:US
Mailing Address - Phone:602-242-3284
Mailing Address - Fax:623-825-3773
Practice Address - Street 1:2200 WEST BETHANY HOME RD
Practice Address - Street 2:SUITE 10
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85015-1937
Practice Address - Country:US
Practice Address - Phone:602-242-3284
Practice Address - Fax:602-246-7335
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1145122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty