# DR BENJAMIN E BLAKLEY DDS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1275690166
- **Authorized official:** DR. BENJAMIN EARL BLAKELY DDS (GENERAL DENTIST OWNER)
- **Authorized official phone:** (317) 257-3799

## Contact information

- **Practice address:** 6437 RUCKER RD, 6437 RUCKER RD, INDIANAPOLIS, IN 46220
- **Practice address phone:** (317) 257-3799
- **Mailing address:** 6437 RUCKER RD, 6437 RUCKER RD, INDIANAPOLIS, IN 46220
- **Mailing address phone:** (317) 257-3799

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 7840 | IN | Yes |

## Other

- **Enumeration date:** 01/02/2007
- **Last updated:** 07/14/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100073160A | — | IN |