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Individual

DR. BRYAN MICHAEL BLANKENSHIP

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.D.S

Contact information

Practice address
1201 N STONEWALL AVE RM 261, OKLAHOMA CITY, OK 73117-1214
(405) 271-5222
(405) 271-7538
Mailing address
1201 N STONEWALL AVE RM 261, OKLAHOMA CITY, OK 73117-1214
(405) 271-5222
(405) 271-7538

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6800
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
35-2382039
OK
Enumeration date
07/15/2016
Last updated
07/15/2016
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