Individual
DR. RILEY DAVIS BLACKHURST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
935 SW HIGGINS AVE, MISSOULA, MT 59803-1460
(406) 721-2686
Mailing address
4620 RATTLESNAKE DR, MISSOULA, MT 59802-3019
(208) 697-2794
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DEN-DEN-LIC-19340
MT
Other
Enumeration date
07/15/2020
Last updated
07/15/2020
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