Individual
HERBERT RAY BLASER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2104 N. COLE RD., BOISE, ID 83704
(208) 376-9280
(208) 376-9280
Mailing address
2104 N. COLE RD., BOISE, ID 83704
(208) 376-9280
(208) 376-9280
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
D1481EN
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002433400
—
ID
Enumeration date
02/01/2011
Last updated
02/01/2011
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