Most Relevant Information
Provider Data
| NPI Number: | 1003804303 |
| Provider Name: | MICHELE LYNN BLOXSON DDS |
| Entity Type: | Individual |
| Taxonomy Code: | 1223S0112X |
| Specialty: | Dentist |
| License Number: | 2901018969 |
Most Important Dates
| Enumeration Date: | 10/11/2005 |
| Last Updated: | 03/19/2008 |
Provider Practice Location
4257 W 3RD ST
DAYTON
OH
454171406
Practice Location Phone/Fax
| Phone: | 9372681665 |
| Fax: |
Provider Mailing Location
415 N GRAND AVE
PUEBLO
CO
810033111
Provider Mailing Phone/Fax
| Phone: | 7195624461 |
| Fax: | 7195847694 |