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Individual

DR. GEORGE MAURY BLACKBURN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.M.D., F.A.G.D.

Contact information

Practice address
12505 HYMEADOW DR, SUITE 2D, AUSTIN, TX 78750-1867
(512) 258-3627
(512) 258-0755
Mailing address
12505 HYMEADOW DR, SUITE 2D, AUSTIN, TX 78750-1867
(512) 258-3627
(512) 258-0755

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
10496
TX

Other

Enumeration date
04/12/2006
Last updated
07/08/2007
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