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Individual

JONATHAN BLINSTRUB

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S

Contact information

Practice address
2240 E. WINROW AVE, US ARMY DENTAL ACTIVITY, FORT HUACHUCA, AZ 85613-7040
(520) 533-3144
Mailing address
2240 E. WINROW AVE, US ARMY DENTAL ACTIVITY, FORT HUACHUCA, AZ 85613-7040
(520) 533-3144

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
63612
CA

Other

Enumeration date
08/05/2014
Last updated
07/20/2016
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