Individual
LAUREN E BLAICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
2700 KANELL BLVD, POPLAR BLUFF, MO 63901-3041
(573) 785-0111
(573) 785-3840
Mailing address
2700 KANELL BLVD, POPLAR BLUFF, MO 63901-3041
(573) 785-0111
(573) 785-3840
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2016017396
MO
Other
Enumeration date
06/01/2016
Last updated
06/01/2016
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