Organization
BLAISDELL DENTAL CENTER, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN D BLAISDELL DDS (PRESIDENT)
(208) 459-2376
Entity
Organization
Contact information
Practice address
1916 ELLIS AVE, CALDWELL, ID 83605-4811
(208) 459-2376
(208) 459-1524
Mailing address
1916 ELLIS AVE, CALDWELL, ID 83605-4811
(208) 459-2376
(208) 459-1524
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
07/09/2008
Last updated
07/09/2008
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