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Individual

DR. BLAINE DONALD AUSTIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S

Contact information

Practice address
5742 S 1475 E, SUITE 100, OGDEN, UT 84403
(801) 399-3701
(801) 399-3702
Mailing address
5742 S 1475 E, SUITE 100, OGDEN, UT 84403-4855
(801) 399-3701
(801) 399-3702

Taxonomy

Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
140958
UT

Other

Enumeration date
02/13/2006
Last updated
11/14/2011
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