Organization
EVANSVILLE ENDODONTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES WILLIAM BLACKBURN DDS (DENTIST)
(812) 402-9600
Entity
Organization
Contact information
Practice address
1449 KIMBER LANE, STE 103A, EVANSVILLE, IN 47715
(812) 402-9600
Mailing address
1449 KIMBER LANE, STE 103A, EVANSVILLE, IN 47715
(812) 402-9600
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
12010139A
IN
1223E0200X
Endodontics
Primary
12010141A
IN
Other
Enumeration date
09/01/2006
Last updated
08/22/2020
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