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Organization
LELAND S BLOUGH JR DMD LTD
Active
Organization
LELAND S BLOUGH JR DMD LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LELAND S BLOUGH JR. DMD (PRESIDENT)
(401) 828-3688
Entity
Organization
Contact information
Practice address
33 COLLEGE HILL RD, SUITE 5A, WARWICK, RI 02886-2776
(401) 828-3688
(401) 828-8588
Mailing address
33 COLLEGE HILL RD, SUITE 5A, WARWICK, RI 02886-2776
(401) 828-3688
(401) 828-8588
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
2455
RI
Other
Enumeration date
03/13/2012
Last updated
03/13/2012
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