Individual
DR. DANIEL G BLACKNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
718 W YELM AVE, YELM, WA 98597-8764
(360) 458-5606
Mailing address
16303 BIRKLAND ST SE, YELM, WA 98597-9569
(267) 978-4626
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DE 60391314
WA
Other
Enumeration date
07/31/2013
Last updated
07/31/2013
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