Individual
ROD BLAINE DONALDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
185 HOSPITAL DRIVE, SUITE #2, EVERETT, PA 15537-7018
(814) 623-9111
(814) 623-9225
Mailing address
185 HOSPITAL DRIVE, SUITE #2, EVERETT, PA 15537-7018
(814) 623-9111
(814) 623-9225
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS029370L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
783661
BCBS
PA
Enumeration date
12/04/2006
Last updated
07/08/2007
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