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General NPI Number Information
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NPI Number | 1528585775
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Entity Type | Organization
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Legal Business Name | GEOFFREY W BLATTER, DMD, PC
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Dates
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Enumeration Date | 08/28/2017
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Last Update Date | 08/28/2017
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Provider Practice Location Address
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Address Line | 100 E OAK ST
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City | LEBANON
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State | OR
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Zip | 97355-4135
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Country | US
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Telephone | 541-451-1176
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Fax | 541-451-1424
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Provider Business Mailing Address
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Address Line | 1305 SE 13TH PL
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City | CANBY
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State | OR
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Zip | 97013-4352
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GEOFFREY W BLATTER
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Credential | DMD
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Telephone | 541-600-0280
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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