Blaisdell, Mark H
Blaisdell, Mark H is an individual health care provider with primary practice located at 625 E 500 S Ste 203 , Bountiful UT 84010-3884. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Blaisdell, Mark H can be contacted via phone (801) 292-6819.Contact Information
Primary practice address
625 E 500 S Ste 203
Bountiful UT 84010-3884
Phone: (801) 292-6819
Fax: (801) 298-8573
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 140507-9922 | Utah |
Profile Details
| NPI number | 1164432084 |
|---|---|
| LBN Legal business name | Blaisdell, Mark H |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 9th, 2006 |
| Last updated | Jul 8th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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