Individual
DR. KENNETH ALLEN BLACKMON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
815 S BRUNDIDGE ST, TROY, AL 36081-3219
(334) 566-8266
(334) 566-7850
Mailing address
PO BOX 248, TROY, AL 36081-0248
(334) 566-8266
(334) 566-7850
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4419CF
AL
Other
Enumeration date
03/27/2007
Last updated
03/13/2023
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