Organization
RONDELL L. BLAKEY, D.D.S., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RONDELL LUCIAN BLAKEY D.D.S. (OWNER)
(919) 435-0632
Entity
Organization
Contact information
Practice address
2621 GARDEN HILL DR APT 108, RALEIGH, NC 27614-6522
(919) 435-0632
Mailing address
2621 GARDEN HILL DR APT 108, RALEIGH, NC 27614-6522
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
8515
NC
Other
Enumeration date
03/12/2010
Last updated
03/12/2010
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