Individual
DR. TRACY ELAINE BLOUNT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S
Contact information
Practice address
1014 FRANKLIN ST SE, GRAND RAPIDS, MI 49507-1327
(616) 452-0400
(616) 243-3728
Mailing address
1014 FRANKLIN ST SE, GRAND RAPIDS, MI 49507-1327
(616) 452-0400
(616) 243-3728
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2759918
—
MI
Enumeration date
09/17/2006
Last updated
07/08/2007
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