DR. Robert Blackwell

NPI #1205964137 in Brookfield, Illinois

Provider Information

NPI Number: 1205964137
Entity Type: Individual
Name: DR. Robert Blackwell
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dentist
Enumeration Date: Mar 1, 2007
Last Updated: Apr 10, 2014

Practice Location

Address: 3631 FOREST AVE
Address 2: UNIT D
City: Brookfield
State: Illinois
ZIP Code: 60513-1763
Phone: (217) 621-3232

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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