Organization
MISTY HORN-BLAKE D.D.S PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MISTY R HORN-BLAKE D.D.S (OWNER/DOCTOR)
(423) 283-8830
Entity
Organization
Contact information
Practice address
1301 SUNSET DR, SUITE 6, JOHNSON CITY, TN 37604-7906
(423) 283-8830
(423) 283-8820
Mailing address
1301 SUNSET DR, SUITE 6, JOHNSON CITY, TN 37604-7906
(423) 283-8830
(423) 283-8820
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8728
TN
Other
Enumeration date
05/12/2008
Last updated
05/12/2008
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