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Individual

DR. ROBIN BRENT BLAKKOLB

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
6800 MAIN ST, SUITE 106, DOWNERS GROVE, IL 60516-3493
(630) 964-5880
Mailing address
6800 MAIN ST, SUITE 106, DOWNERS GROVE, IL 60516-3493
(630) 964-5880

Taxonomy

Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
021-001127
IL

Other

Enumeration date
11/02/2006
Last updated
04/23/2008
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