Individual
BLAKE NICHOLAS BACHNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1470 PANTOPS MOUNTAIN PL STE 1, CHARLOTTESVILLE, VA 22911-4662
(434) 260-6836
Mailing address
11100 EUCLID AVE, CLEVELAND, OH 44106-1716
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
0401419372
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/18/2023
Last updated
05/29/2025
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