Provider Demographics
NPI:1033952106
Name:BLANCHARD MOLAR
Entity type:Organization
Organization Name:BLANCHARD MOLAR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KIRK
Authorized Official - Middle Name:
Authorized Official - Last Name:MURRAY
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:405-328-1240
Mailing Address - Street 1:1119 N COUNCIL AVE
Mailing Address - Street 2:
Mailing Address - City:BLANCHARD
Mailing Address - State:OK
Mailing Address - Zip Code:73010-8037
Mailing Address - Country:US
Mailing Address - Phone:405-485-2020
Mailing Address - Fax:405-485-8779
Practice Address - Street 1:1119 N COUNCIL AVE
Practice Address - Street 2:
Practice Address - City:BLANCHARD
Practice Address - State:OK
Practice Address - Zip Code:73010-8037
Practice Address - Country:US
Practice Address - Phone:405-485-2020
Practice Address - Fax:405-485-8779
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-17
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental