Organization
BLACKWOOD FAMILY DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ERIC BLACKWOOD DDS (DENTIST)
(785) 754-2441
Entity
Organization
Contact information
Practice address
501 GARFIELD ST, QUINTER, KS 67752-9795
(785) 754-2441
(785) 754-2466
Mailing address
PO BOX 557, 501 GARFIELD, QUINTER, KS 67752-0557
(785) 754-2441
(785) 754-2466
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
60189
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
103514
DORAL LOCATION NUMBER
KS
01
—
116736
BLUE CROSS BLUE SHIELD
KS
Enumeration date
10/24/2006
Last updated
08/22/2020
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