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Individual

BLAIRE ALLYN ERSTENIUK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DDS MS

Contact information

Practice address
609 S KELLY AVE STE A1, EDMOND, OK 73003-5696
(405) 509-8932
(405) 531-0808
Mailing address
609 S KELLY AVE STE A1, EDMOND, OK 73003-5696
(405) 509-8932
(405) 531-0808

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6184
OK
1223P0300X
Periodontics
6184
OK
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
03/21/2010
Last updated
01/06/2021
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