| Blackstockdentalcorp | |
|
12110 Woodside Ave Lakeside CA 92040-3012 | |
| (619) 443-0444 | |
| (619) 443-0050 |
| Full Name | Blackstockdentalcorp |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 12110 Woodside Ave, Lakeside, California |
| Authorized Official Name and Position | Burch Lee Blackstock (DENTIST) |
| Authorized Official Contact | 6194430444 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Blackstockdentalcorp 12110 Woodside Ave. Lakeside CA 92040-3012 Ph: (619) 443-0444 | Blackstockdentalcorp 12110 Woodside Ave Lakeside CA 92040-3012 Ph: (619) 443-0444 |
| NPI Number | 1417168881 |
|---|---|
| Provider Enumeration Date | 05/25/2007 |
| Last Update Date | 02/10/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417168881 | NPI | - | NPPES |
| 42123 | Other | CA | DENTAL BOARD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 42123 (California) | Primary |
Grant And Pham Dental Corporation Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 9710 Winter Gardens Blvd, Lakeside, CA 92040 Phone: 619-443-8447 | |
James A. Cloyd Dds Inc. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 9929 Channel Rd, Lakeside, CA 92040 Phone: 619-561-4430 | |
East County Family Dentistry Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 9710 Winter Gardens Blvd, Suite # C, Lakeside, CA 92040 Phone: 619-443-8447 Fax: 619-443-5450 | |
Arthur Santos Dds Corp Dental Clinic Medicare: Medicare Enrolled Practice Location: 12110 Woodside Ave, Lakeside, CA 92040 Phone: 619-443-0444 | |
Cluff Dds A Professional Dental Corporation Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 9447 Winter Gardens Blvd, Lakeside, CA 92040 Phone: 619-443-3948 Fax: 619-443-3938 |