| Organization Name: | PAUL M BLANK D.D.S., P.C. |
| NPI Number: | 1225287790 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JANICE E JACKSON (OFFICE MANAGER) |
| Mailing Address: | 213 Spring St Three Rivers |
| State: | MI US |
| Postal Code: | 490932150 |
| Phone Number: | 2692795278 |
| Fax Number: | 2692781014 |
| NPI Enumeration Date: | 09/09/2008 |
| NPI Last Update Date: | 09/09/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 385H00000X |
| License Number: | 2901015109 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Respite Care Facility |
| Taxonomy Classification: | Respite Care |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |