Individual
DR. BLAKE ANDREW JOHNSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
11010 QUAKER AVE, LUBBOCK, TX 79424-8316
(806) 797-6453
Mailing address
11010 QUAKER AVE, LUBBOCK, TX 79424-8316
(806) 797-6453
(806) 791-2273
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
28082
TX
Other
Enumeration date
07/07/2012
Last updated
04/04/2019
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