Individual
DR. PETER WILLIAM BLACKBURN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1817 RUDDIMAN DR, NORTH MUSKEGON, MI 49445-3145
(231) 744-2458
(231) 744-3423
Mailing address
1817 RUDDIMAN DR, NORTH MUSKEGON, MI 49445-3145
(231) 744-2458
(231) 744-3423
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2901016769
MI
Other
Enumeration date
01/03/2007
Last updated
07/08/2007
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