Provider Demographics
NPI:1013541366
Name:CB HEALTH
Entity Type:Organization
Organization Name:CB HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BLALOCK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:573-450-0362
Mailing Address - Street 1:1406 TRIAD CENTER DR
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERS
Mailing Address - State:MO
Mailing Address - Zip Code:63376-7351
Mailing Address - Country:US
Mailing Address - Phone:636-441-7440
Mailing Address - Fax:
Practice Address - Street 1:1406 TRIAD CENTER DR
Practice Address - Street 2:
Practice Address - City:SAINT PETERS
Practice Address - State:MO
Practice Address - Zip Code:63376-7351
Practice Address - Country:US
Practice Address - Phone:636-441-7440
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-26
Last Update Date:2020-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty