Organization
FAMILY DENTAL CARE OF DOTHAN, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEITH A BLACKMON D.D.S. (OWNER)
(334) 792-5711
Entity
Organization
Contact information
Practice address
107 PROFESSIONAL LN, DOTHAN, AL 36303-3875
(334) 792-5711
(334) 678-8157
Mailing address
107 PROFESSIONAL LN, DOTHAN, AL 36303-3875
(334) 792-5711
(334) 678-8157
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4491
AL
Other
Enumeration date
10/26/2006
Last updated
08/18/2011
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