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Organization

BLANKENSHIP DENTAL AT OAKLEAF PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. BRYAN KEITH BLANKENSHIP D.D.S. (DENTIST/OWNER)
(904) 236-8030
Entity
Organization

Contact information

Practice address
5000 SAWGRASS VILLAGE CIR, SUITE 23, PONTE VEDRA BEACH, FL 32082-5045
(904) 236-8030
(574) 825-2410
Mailing address
9590 APPLECROSS RD, SUITE 12-106, JACKSONVILLE, FL 32222-5819
(904) 236-8030
(574) 825-2410

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
193344
FL

Other

Enumeration date
06/19/2008
Last updated
06/19/2008
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