Individual
DR. MICHAEL D. BLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
6363 POPLAR AVE, SUITE 110, MEMPHIS, TN 38119-4831
(901) 415-2536
(901) 415-6292
Mailing address
6363 POPLAR AVE, SUITE 110, MEMPHIS, TN 38119-4831
(901) 415-2536
(901) 415-6292
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
DS7318
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0016888
—
TN
Enumeration date
10/10/2005
Last updated
07/09/2007
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