Individual
DEANNE C BLAZEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
401 PILOT CT # D, WAUKESHA, WI 53188-2439
(262) 542-2970
Mailing address
S60W24120 RED WING DR, WAUKESHA, WI 53189-9508
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3952
WI
Other
Enumeration date
12/28/2006
Last updated
07/08/2007
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