Individual
KRIS M BLODGETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
354 W ADAMS ST, SISTERS, OR 97759-0901
(541) 549-0973
(541) 549-9542
Mailing address
PO BOX 901, 354 W ADAMS STREET, SISTERS, OR 97759-0901
(541) 549-0973
(541) 549-9542
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D8230
OR
Other
Enumeration date
11/15/2006
Last updated
07/08/2007
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