Individual
DR. BENJAMIN T BLACKISTON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
3309 CUMMINGS HWY, SUITE F, CHATTANOOGA, TN 37419-2360
(423) 821-3279
(423) 821-1620
Mailing address
3309 CUMMINGS HWY, SUITE F, CHATTANOOGA, TN 37419-2360
(423) 821-3279
(423) 821-1620
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS0000007632
TN
Other
Enumeration date
10/17/2005
Last updated
07/08/2007
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