Individual
DR. JAY MAYNARD BLICKENSTAFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2 WAYSIDE AVE, HAGERSTOWN, MD 21740-3994
(301) 733-9020
(301) 733-0136
Mailing address
2 WAYSIDE AVE, HAGERSTOWN, MD 21740-3994
(301) 733-9020
(301) 733-0136
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
MD9244
MD
Other
Enumeration date
09/28/2006
Last updated
07/08/2007
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