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Individual
DR. CALEB BLACKBURN
Active
Individual
DR. CALEB BLACKBURN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS, MD
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
11013
SC
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
202500269
NC
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
73026
TN
Other
Enumeration date
04/03/2018
Last updated
04/13/2026
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