Individual
MARYELLEN BLASING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D.H.
Contact information
Practice address
106 LA VISTA RD, PUEBLO, CO 81005-2617
(719) 214-6270
Mailing address
106 LA VISTA RD, PUEBLO, CO 81005-2617
(719) 214-6270
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
2696
CO
Other
Enumeration date
08/31/2012
Last updated
08/31/2012
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