# EVANSVILLE ENDODONTICS

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

## Provider details

- **NPI number:** 1306948419
- **Authorized official:** DR. JAMES WILLIAM BLACKBURN DDS (DENTIST)
- **Authorized official phone:** (812) 402-9600

## Contact information

- **Practice address:** 1449 KIMBER LANE, STE 103A, EVANSVILLE, IN 47715
- **Practice address phone:** (812) 402-9600
- **Mailing address:** 1449 KIMBER LANE, STE 103A, EVANSVILLE, IN 47715
- **Mailing address phone:** (812) 402-9600

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223E0200X | Endodontics | 12010139A | IN | — |
| 1223E0200X | Endodontics | 12010141A | IN | Yes |

## Other

- **Enumeration date:** 09/01/2006
- **Last updated:** 08/22/2020