Individual
DEVON JAMES BLOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2563 E CALUMET ST, APPLETON, WI 54915-4748
(920) 731-6416
Mailing address
N9305 NOE RD, APPLETON, WI 54915-5653
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
600150815
WI
Other
Enumeration date
06/27/2023
Last updated
12/20/2024
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