Individual
BLAIN VANNICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
5901 RILEY PARK DR STE A, FORT SMITH, AR 72916-6104
(479) 226-3500
Mailing address
9021 LOGWOOD LN, FORT SMITH, AR 72916-5036
(303) 941-0377
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4780
AR
Other
Enumeration date
07/23/2024
Last updated
07/23/2024
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