# GALEN VAN BLARICUM, DDS, PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1619075439
- **Authorized official:** GALEN R VAN BLARICUM DDS (OWNER)
- **Authorized official phone:** (785) 843-2636

## Contact information

- **Practice address:** 3310 MESA WAY, LAWRENCE, KS 66049-2361
- **Practice address phone:** (785) 843-2636
- **Practice address fax:** (785) 838-9577
- **Mailing address:** 3310 MESA WAY, LAWRENCE, KS 66049-2361
- **Mailing address phone:** (785) 843-2636
- **Mailing address fax:** (785) 838-9577

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 09/20/2006
- **Last updated:** 08/22/2020