Organization
BREMEN DENTAL DEPOT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHEN J BLANK DDS (OWNER)
(678) 822-4714
Entity
Organization
Contact information
Practice address
302 LAUREL ST, BREMEN, GA 30110-2124
(770) 537-4439
(770) 537-3708
Mailing address
302 LAUREL ST, BREMEN, GA 30110-2124
(770) 537-4439
(770) 537-3708
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
09/13/2017
Last updated
07/21/2022
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