Individual
MS. MARY BLASKO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.D.H.
Contact information
Practice address
11103 SE MAIN ST STE B, MILWAUKIE, OR 97222-7251
(503) 654-0613
(503) 654-4087
Mailing address
11103 SE MAIN ST STE B, MILWAUKIE, OR 97222-7251
(503) 654-0613
(503) 654-4087
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
H2699
OR
Other
Enumeration date
04/23/2010
Last updated
04/23/2010
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