Organization
BLONG INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERESA MATTHYS (OFFICE MANAGER)
(715) 373-2612
Entity
Organization
Contact information
Practice address
16 E BAYFIELD ST, WASHBURN, WI 54891-4401
(715) 373-2612
Mailing address
PO BOX 415, WASHBURN, WI 54891-0415
(715) 373-2612
(715) 812-1114
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
08/29/2022
Last updated
08/29/2022
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