Individual
BLAINE AMMON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
390 4TH ST N STE 101, ST PETERSBURG, FL 33701-2802
(727) 282-1980
Mailing address
334 2ND AVE S APT 608, ST PETERSBURG, FL 33701-4750
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN28141
FL
Other
Enumeration date
06/26/2020
Last updated
04/07/2025
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