Individual
DR. GEORGE F BLAICH IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
1300 N WESTWOOD BLVD, POPLAR BLUFF, MO 63901-3314
(573) 785-0111
Mailing address
1300 N WESTWOOD BLVD, POPLAR BLUFF, MO 63901-3314
(573) 785-0111
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
13547
MO
Other
Enumeration date
12/14/2006
Last updated
07/08/2007
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