Blaisdell Dental Center, PA

NPI #1881857753 in Caldwell, Idaho

Provider Information

NPI Number: 1881857753
Entity Type: Organization
Organization Name: Blaisdell Dental Center, PA
Primary Specialty: Dentist - General Practice
Enumeration Date: Jul 9, 2008
Last Updated: Jul 9, 2008

Practice Location

Address: 1916 ELLIS AVE
City: Caldwell
State: Idaho
ZIP Code: 83605-4811
Phone: (208) 459-2376

Authorized Official

Name: DR. JOHN D BLAISDELL, DDS
Title: PRESIDENT
Phone: (208) 459-2376

Specialties & Taxonomy Codes

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

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