Individual
DR. LEIGH J BLAKISTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
102 WESTERN AVE, SUFFOLK, VA 23434-4434
(757) 539-7695
(757) 538-9419
Mailing address
102 WESTERN AVE, SUFFOLK, VA 23434-4434
(757) 539-7695
(757) 538-9419
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401414510
VA
Other
Enumeration date
07/14/2014
Last updated
07/14/2014
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