# C. SUE VANBLARICUM, DDS, PC

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

## Provider details

- **NPI number:** 1710091681
- **Authorized official:** DR. C. SUE VANBLARICUM DDS (PRESIDENT)
- **Authorized official phone:** (615) 666-6155

## Contact information

- **Practice address:** 412 COLLEGE ST, LAFAYETTE, TN 37083-1705
- **Practice address phone:** (615) 666-6155
- **Practice address fax:** (615) 666-7525
- **Mailing address:** 412 COLLEGE ST, LAFAYETTE, TN 37083-1705
- **Mailing address phone:** (615) 666-6155
- **Mailing address fax:** (615) 666-7525

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | DS0000005005 | TN | Yes |

## Other

- **Enumeration date:** 08/18/2006
- **Last updated:** 08/22/2020