Individual
TRENTON MATTHEW BLAHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2204 KENTUCKY AVE, PLATTE CITY, MO 64079-7628
(816) 858-2027
Mailing address
2204 KENTUCKY AVE, PLATTE CITY, MO 64079-7628
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2017017278
MO
Other
Enumeration date
06/02/2017
Last updated
06/02/2017
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