Individual
DR. DANIEL MILLER BLACKSHARE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
737 E 9TH ST, RECTOR, AR 72461-2705
(870) 595-3463
Mailing address
PO BOX 284, RECTOR, AR 72461-0284
(870) 595-4220
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4366
AR
Other
Enumeration date
06/20/2019
Last updated
06/20/2019
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