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Organization

BRYAN KEITH BLANKENSHIP DDS PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. BRYAN KEITH BLANKENSHIP DDS (DENTIST/OWNER)
(904) 280-0070
Entity
Organization

Contact information

Practice address
5000 SAWGRASS VILLAGE CIR, SUITE 23, PONTE VEDRA, FL 32082-5045
(904) 280-0070
(904) 280-0079
Mailing address
5000 SAWGRASS VILLAGE CIR, SUITE 23, PONTE VEDRA, FL 32082-5045
(904) 280-0070
(904) 280-0079

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
193344
FL

Other

Enumeration date
06/30/2008
Last updated
04/06/2011
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