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Organization
BLACKWELL DENTAL PLLC
Active
Organization
BLACKWELL DENTAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANDREW NICHOLAS BLACKWELL DMD (OWNER/MANAGER/GENERAL DENTIST)
(757) 581-9965
Entity
Organization
Contact information
Practice address
387 MAIN ST S, WOODBURY, CT 06798-3412
(757) 581-9965
Mailing address
100 PLEASANT DR, SOUTHBURY, CT 06488-3231
(757) 581-9965
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
11-610
CT
Other
Enumeration date
04/09/2018
Last updated
12/03/2020
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