| Bryan Keith Blankenship Dds Pa | |
|
5000 Sawgrass Village Cir Suite 23 Ponte Vedra FL 32082-5045 | |
| (904) 280-0070 | |
| (904) 280-0079 |
| Full Name | Bryan Keith Blankenship Dds Pa |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 5000 Sawgrass Village Cir, Ponte Vedra, Florida |
| Authorized Official Name and Position | Bryan Keith Blankenship (DENTIST/OWNER) |
| Authorized Official Contact | 9042800070 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bryan Keith Blankenship Dds Pa 5000 Sawgrass Village Cir Suite 23 Ponte Vedra FL 32082-5045 Ph: (904) 280-0070 | Bryan Keith Blankenship Dds Pa 5000 Sawgrass Village Cir Suite 23 Ponte Vedra FL 32082-5045 Ph: (904) 280-0070 |
| NPI Number | 1013179258 |
|---|---|
| Provider Enumeration Date | 06/30/2008 |
| Last Update Date | 04/06/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013179258 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 193344 (Florida) | Primary |
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