Provider Demographics
NPI:1023403433
Name:BLASS RICHTSMEIER DDS I LLC
Entity type:Organization
Organization Name:BLASS RICHTSMEIER DDS I LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AARON
Authorized Official - Middle Name:
Authorized Official - Last Name:BLASS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-965-1800
Mailing Address - Street 1:1360 S 5TH ST
Mailing Address - Street 2:SUITE 270
Mailing Address - City:SAINT CHARLES
Mailing Address - State:MO
Mailing Address - Zip Code:63301-2449
Mailing Address - Country:US
Mailing Address - Phone:636-940-2543
Mailing Address - Fax:888-278-0530
Practice Address - Street 1:1360 S 5TH ST
Practice Address - Street 2:SUITE 270
Practice Address - City:SAINT CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63301-2449
Practice Address - Country:US
Practice Address - Phone:636-940-2543
Practice Address - Fax:888-278-0530
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-02
Last Update Date:2015-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty