Organization
MOUNTAIN WEST DERM - BLACKHART PLLC
Active
Other names
Bend Dermatology Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
BRET S BLACKHART MD (MD)
(775) 336-3624
Entity
Organization
Contact information
Practice address
2747 NE CONNERS AVE, BEND, OR 97701-8738
(541) 382-5712
Mailing address
640 W MOANA LN, RENO, NV 89509-4903
(775) 324-0699
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Enumeration date
11/22/2017
Last updated
11/22/2017
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