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Individual

DR. PETER J BLODGETT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
108 5TH AVE, DECORAH, IA 52101-1319
(563) 382-3657
(563) 382-0739
Mailing address
108 5TH AVE, DECORAH, IA 52101-1319
(563) 382-3657
(563) 382-0739

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7396
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0063404
IA
Enumeration date
10/17/2006
Last updated
04/09/2024
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