Individual
KEITH ALLAN BLALOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS,MS
Contact information
Practice address
12340 BANDERA RD, SUITE 102, HELOTES, TX 78023-4574
(210) 695-9996
(210) 695-9566
Mailing address
12340 BANDERA RD, SUITE 102, HELOTES, TX 78023-4574
(210) 695-9996
(210) 695-9566
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
15290
TX
Other
Enumeration date
08/09/2006
Last updated
02/15/2012
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