| Blythe A O'donnell, Pllc | |
|
812 Cypress St Manistee MI 49660-2110 | |
| (231) 723-6512 | |
| (231) 723-0000 |
| Full Name | Blythe A O'donnell, Pllc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 812 Cypress St, Manistee, Michigan |
| Authorized Official Name and Position | Blythe A O'donnell (DENTIST) |
| Authorized Official Contact | 2317236512 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Blythe A O'donnell, Pllc 812 Cypress St Manistee MI 49660-2110 Ph: (231) 723-6512 | Blythe A O'donnell, Pllc 812 Cypress St Manistee MI 49660-2110 Ph: (231) 723-6512 |
| NPI Number | 1255846754 |
|---|---|
| Provider Enumeration Date | 12/06/2017 |
| Last Update Date | 12/06/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255846754 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 18268 (Michigan) | Primary |
| 261QD0000X | Clinic/center - Dental | 11462 (Michigan) | Secondary |
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