Individual
DR. MARK BLASKOVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
120 S CRESCENT DR, PUEBLO WEST, CO 81007-2787
(719) 647-9433
Mailing address
120 S CRESCENT DR, PUEBLO WEST, CO 81007
(719) 647-9433
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
28248
TX
1223G0001X
General Practice Dentistry
Primary
DEN.00201877
CO
Other
Enumeration date
07/24/2012
Last updated
07/21/2022
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