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Individual

BLAINE GUENTHER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
4102 PINION DR, USAF ACADEMY, CO 80840-2502
(719) 333-5591
Mailing address
1100 WILFORD HALL LOOP BLDG 4554, JBSA LACKLAND, TX 78236-5638

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
016.0133862
VT
122300000X
Dentist
DEN.00205468
CO
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DEN.00205468
CO
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
04/29/2018
Last updated
09/12/2025
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