| Organization Name: | DR. JANICE I. BLOUGH-LABUDA, DMD, PA |
| NPI Number: | 1104154376 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JANICE IRENE BLOUGH-LABUDA (DENTIST/OWNER) |
| Mailing Address: | 444 National Hwy Lavale |
| State: | MD US |
| Postal Code: | 215027129 |
| Phone Number: | 3017242978 |
| Fax Number: | 3017246652 |
| NPI Enumeration Date: | 11/30/2009 |
| NPI Last Update Date: | 11/30/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QD0000X |
| License Number: | 12554 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MD |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Dental |
| Taxonomy Definition: | |