Individual
DR. MICHAEL SHANAHAN BLACKWOOD
Active
Individual
DR. MICHAEL SHANAHAN BLACKWOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS, MS
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
0401007606
VA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
11187
MD
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
DEN5374
DC
Other
Enumeration date
08/21/2009
Last updated
08/21/2009
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