Individual
DR. JOHN WALTON BLACKMAN II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1409 PLAZA WEST ROAD, #H, WINSTON SALEM, NC 27103
(336) 760-9258
(336) 659-9258
Mailing address
1409 PLAZA WEST ROAD, SUITE H, WINSTON SALEM, NC 27103
(336) 760-9258
(336) 659-9258
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
3165
NC
Other
Enumeration date
04/17/2007
Last updated
07/08/2007
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