Organization
PAUL M BLANK D.D.S., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANICE E JACKSON (OFFICE MANAGER)
(269) 279-5278
Entity
Organization
Contact information
Practice address
213 SPRING ST, THREE RIVERS, MI 49093-2150
(269) 279-5278
(269) 278-1014
Mailing address
213 SPRING ST, THREE RIVERS, MI 49093-2150
(269) 279-5278
(269) 278-1014
Taxonomy
Speciality
Code
Description
License number
State
385H00000X
Respite Care
Primary
2901015109
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2826055
—
MI
Enumeration date
09/09/2008
Last updated
09/09/2008
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