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Organization

BBCCS PLLC

Active
Other names
Creekview Dental
Organization subpart
No

Provider details

NPI number
Authorized official
DR. BRIAN EUGENE BLACKWELL DDS (DENTIST)
(406) 698-0293
Entity
Organization

Contact information

Practice address
2145 WOODLANE DR STE 104, WOODBURY, MN 55125-1920
(651) 738-8204
Mailing address
11077 SWEETWATER PATH, SAINT PAUL, MN 55129-5292
(406) 698-0293

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary

Other

Enumeration date
02/03/2025
Last updated
02/03/2025
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