Individual
DR. JEFF BLOMSTEDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1510 E 20TH ST, SUITE B, FARMINGTON, NM 87401-9033
(505) 327-6151
Mailing address
4015 ABBEY RD, FARMINGTON, NM 87402-2901
(308) 737-0684
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DD4520
NM
Other
Enumeration date
06/15/2016
Last updated
07/15/2016
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