Individual
DR. CLINTON T BLACKWOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
715 E 3900 S, SUITE 104, SALT LAKE CITY, UT 84107-2182
(801) 266-7737
(801) 266-7767
Mailing address
715 E 3900 S, SUITE 104, SALT LAKE CITY, UT 84107-2182
(801) 266-7737
(801) 266-7767
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5936346-9922
UT
Other
Enumeration date
09/24/2006
Last updated
07/08/2007
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