Organization
DONALD R. BLACKSTONE, D.M.D., PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GREGORY MARK BLACKSTONE D.D.S. (ORTHODONTIST)
(207) 762-7881
Entity
Organization
Contact information
Practice address
379 CENTERLINE RD, PRESQUE ISLE, ME 04769-5227
(207) 762-7881
Mailing address
379 CENTERLINE RD, PRESQUE ISLE, ME 04769-5227
(207) 762-7881
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
3027
ME
Other
Enumeration date
07/16/2007
Last updated
07/16/2007
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