Individual
ADRIEN BLACKMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.A.
Contact information
Practice address
12420 CUMMING HWY, STE 306, CANTON, GA 30115-7568
(678) 947-3600
Mailing address
138 BROOKWOOD TRL, WALESKA, GA 30183-3175
(404) 735-2030
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
—
GA
Other
Enumeration date
03/14/2014
Last updated
03/14/2014
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