Individual
RENEE BLANKEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4300 GRAVOIS RD, HOUSE SPRINGS, MO 63051-2304
(636) 321-0150
Mailing address
227 E MAIN ST, FESTUS, MO 63028-1952
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
2009020164
MO
Other
Enumeration date
09/02/2014
Last updated
10/27/2014
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