Organization
CHARLTON BRYAN BLAKENEY D.M.D.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAREN BLAKENEY (OWNER)
(228) 896-0019
Entity
Organization
Contact information
Practice address
12182 HIGHWAY 49, GULFPORT, MS 39503-3125
(228) 832-4224
(228) 832-4896
Mailing address
12182 HIGHWAY 49, GULFPORT, MS 39503-3125
(228) 832-4224
(228) 832-4896
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
10/23/2014
Last updated
10/23/2014
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