Dr. Brett Blacher
Dentist, General Practice in Lombard, IL. Individual provider (NPI-1).
NPI number1376615948
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1376615948
- Entity type
- Individual (NPI-1)
- Name
- Dr. Brett Blacher
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Nov 15, 2006
- Last updated
- Jul 8, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | 019025192 | IL | Yes |
Practice location
450 E 22nd St Ste 201Lombard, IL 60148-6176
Phone 630-916-0701 · Fax 630-916-4647
Mailing address
450 E 22nd St Ste 201Lombard, IL 60148-6176
Phone 630-916-0701 · Fax 630-916-4647
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