Individual
DR. H. DWAINE BLAKEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1208 EAST BYERS AVE, OWENSBORO, KY 42303-7558
(270) 926-3838
(270) 926-0452
Mailing address
745 SCHERM RD, DENTAL ARTS BUILDING, OWENSBORO, KY 42301-6022
(270) 926-9907
(270) 926-7801
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4312
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
60043122
—
KY
Enumeration date
08/29/2006
Last updated
12/20/2011
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