Organization
BRENT L BLAYLOCK DDS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRENT LASHLEY BLAYLOCK DDS (OWNER PRESIDENT)
(919) 493-8036
Entity
Organization
Contact information
Practice address
3206 OLD CHAPEL HILL RD STE 300, DURHAM, NC 27707-3688
(919) 493-8036
(919) 493-6060
Mailing address
3206 OLD CHAPEL HILL RD STE 300, DURHAM, NC 27707-3688
(919) 493-8036
(919) 493-6060
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4970
NC
Other
Enumeration date
08/17/2006
Last updated
07/07/2008
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