Organization
OAK PARK DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH ALLEN BLACKMON JR. DMD (SOLE MEMBER)
(334) 566-8266
Entity
Organization
Contact information
Practice address
98 OAK PARK DR, TROY, AL 36079-3085
(334) 566-8266
(334) 566-7850
Mailing address
PO BOX 248, TROY, AL 36081-0248
(334) 566-8266
(334) 566-7850
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
08/06/2019
Last updated
03/13/2023
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