Organization
DR BENJAMIN E BLAKLEY DDS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BENJAMIN EARL BLAKELY DDS (GENERAL DENTIST OWNER)
(317) 257-3799
Entity
Organization
Contact information
Practice address
6437 RUCKER RD, 6437 RUCKER RD, INDIANAPOLIS, IN 46220
(317) 257-3799
Mailing address
6437 RUCKER RD, 6437 RUCKER RD, INDIANAPOLIS, IN 46220
(317) 257-3799
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
7840
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100073160A
—
IN
Enumeration date
01/02/2007
Last updated
07/14/2008
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