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Individual

SUSAN D BLANKENSHIP

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DMD INC

Contact information

Practice address
35036 US HIGHWAY 19 N, PALM HARBOR, FL 34684-1925
(727) 446-4699
(727) 771-6804
Mailing address
35036 US HIGHWAY 19 N, PALM HARBOR, FL 34684-1925
(727) 446-4699
(727) 771-6804

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
DN0013950
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
071201900
FL
Enumeration date
03/22/2007
Last updated
10/03/2023
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