| Charlton Bryan Blakeney D.m.d. | |
|
12182 Highway 49 Gulfport MS 39503-3125 | |
| (228) 832-4224 | |
| (228) 832-4896 |
| Full Name | Charlton Bryan Blakeney D.m.d. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 12182 Highway 49, Gulfport, Mississippi |
| Authorized Official Name and Position | Karen Blakeney (OWNER) |
| Authorized Official Contact | 2288960019 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Charlton Bryan Blakeney D.m.d. 12182 Highway 49 Gulfport MS 39503-3125 Ph: (228) 832-4224 | Charlton Bryan Blakeney D.m.d. 12182 Highway 49 Gulfport MS 39503-3125 Ph: (228) 832-4224 |
| NPI Number | 1417352204 |
|---|---|
| Provider Enumeration Date | 10/23/2014 |
| Last Update Date | 10/23/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417352204 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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