Blen, Michael D.

Blen, Michael D. is an individual health care provider with primary practice located at 6363 Poplar Ave Suite 110, Memphis TN 38119-4831. He recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as his primary health care specialty. Blen, Michael D. can be contacted via phone (901) 415-2536.

Contact Information

Primary practice address
6363 Poplar Ave Suite 110 Memphis TN 38119-4831
Phone: (901) 415-2536
Fax: (901) 415-6292
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Pediatric Dentistry 1223P0221X DS7318 Tennessee

Profile Details

NPI number 1174511604
LBN Legal business name Blen, Michael D.
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 10th, 2005
Last updated Jul 9th, 2007 - about 17 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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Identifiers

StateTypeNumberIssuer
All States NPI 1174511604 NPPES
Tennessee MEDICAID 0016888

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