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Organization

BRYAN BLACKSHARE DDS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. SAMMY BRYAN BLACKSHARE (OWNER)
(870) 595-3463
Entity
Organization

Contact information

Practice address
737 E 9TH ST, RECTOR, AR 72461-2705
(870) 595-3463
(870) 595-3208
Mailing address
PO BOX 363, RECTOR, AR 72461-0363
(870) 595-3463

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary

Other

Enumeration date
06/26/2019
Last updated
06/26/2019
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