Provider Demographics
NPI:1386771970
Name:BLANCHARD, HEATHER NEAL (DDS)
Entity type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:NEAL
Last Name:BLANCHARD
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 1ST AVE E
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901-4561
Mailing Address - Country:US
Mailing Address - Phone:406-752-2180
Mailing Address - Fax:406-752-5276
Practice Address - Street 1:210 1ST AVE E
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-4561
Practice Address - Country:US
Practice Address - Phone:406-752-2180
Practice Address - Fax:406-752-5276
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2011-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT2155122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist