Individual
CARLLA BLANTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
16B FELTON PL, CARTERSVILLE, GA 30120-2152
(770) 382-3536
(770) 382-1915
Mailing address
16B FELTON PL, CARTERSVILLE, GA 30120-2152
(770) 382-3536
(770) 382-1915
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
DN012515
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DN012515
LICENSE
—
Enumeration date
12/27/2006
Last updated
03/07/2023
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