Individual
JARED BLACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
6848 E BROWN RD, MESA, AZ 85207-3706
(480) 418-9207
Mailing address
6848 E BROWN RD, MESA, AZ 85207-3706
(480) 418-9207
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
7955
NC
Other
Enumeration date
08/08/2006
Last updated
07/09/2019
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