Lynn R. Blaisdell, Dds, PA

NPI #1881853208 in Boise, Idaho

Provider Information

NPI Number: 1881853208
Entity Type: Organization
Organization Name: Lynn R. Blaisdell, Dds, PA
Primary Specialty: Dentist - General Practice
Enumeration Date: Jun 2, 2008
Last Updated: Jun 2, 2008

Practice Location

Address: 8877 W HACKAMORE DR
City: Boise
State: Idaho
ZIP Code: 83709-1671
Phone: (208) 377-9696

Authorized Official

Name: DR. LYNN R BLAISDELL, DDS
Title: PRESIDENT/OWNER
Phone: (208) 377-9696

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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