Individual
DR. WILLIAM SIDNEY BLACKMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
23377 ILLAHEE DR, ALPINE, CA 91901-5413
(208) 251-3382
Mailing address
23377 ILLAHEE DR, ALPINE, CA 91901-5413
(208) 251-3382
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
D-4516
ID
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
D-4516
ID
Other
Enumeration date
08/05/2013
Last updated
04/21/2025
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