Individual
DR. BERNARD JACOB BLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
875 UNION AVE, MEMPHIS, TN 38103-3513
(901) 491-8178
Mailing address
875 UNION AVE, MEMPHIS, TN 38103-3513
(901) 491-8178
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS2053
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DS 2053
DENTAL LICENSE
TN
Enumeration date
05/15/2013
Last updated
05/15/2013
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