Individual
DR. MELISSA J BLANK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S
Contact information
Practice address
907 11TH ST, DE WITT, IA 52742-1207
(563) 659-3411
(563) 659-2831
Mailing address
907 11TH ST, DE WITT, IA 52742-1207
(563) 659-3411
(563) 659-2831
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
08740
IA
Other
Enumeration date
07/06/2010
Last updated
07/06/2010
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