Individual
DARRIN BLACKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
500 INDIANA AVE, WINSLOW, AZ 86047-2169
(928) 289-4646
Mailing address
500 INDIANA AVE, WINSLOW, AZ 86047-2169
(928) 289-4646
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
53174
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
134822
—
AZ
Enumeration date
03/14/2007
Last updated
07/09/2007
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