Individual
DR. HARRY BLACKMON JR.
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
500 E MAIN ST, BENNETTSVILLE, SC 29512-3210
(843) 479-4085
(843) 479-8991
Mailing address
500 E MAIN ST, BENNETTSVILLE, SC 29512-3210
(843) 479-4085
(843) 479-8991
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2392
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002392
—
SC
Enumeration date
12/07/2005
Last updated
07/08/2007
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