Individual
DR. JARED V BLOXHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1363 COLUMBIA PARK TRL STE 101, RICHLAND, WA 99352-4770
(509) 578-5770
(509) 578-5774
Mailing address
1363 COLUMBIA PARK TRL STE 101, RICHLAND, WA 99352-4770
(509) 578-5770
(509) 578-5774
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
10135
WA
1223X2210X
Orofacial Pain Dentistry
Primary
10135
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5049150
—
WA
Enumeration date
09/20/2006
Last updated
03/16/2020
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