Individual
DR. TED CRAIG BLECKSTEIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S., M.S.
Contact information
Practice address
1085 RIVER VILLAGE LN, AFTON, TN 37616-6219
(423) 639-4462
Mailing address
1085 RIVER VILLAGE LN, AFTON, TN 37616-6219
(423) 639-4462
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
9090
TN
Other
Enumeration date
12/18/2007
Last updated
09/26/2010
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