Smiles by Dr. Blackmon
NPI #1306260401 in Shaker Heights, Ohio
Provider Information
- NPI Number
- 1306260401
- Entity Type
- Organization
- Organization Name
- Smiles by Dr. Blackmon
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Feb 10, 2014
- Last Updated
- Feb 10, 2014
Practice Location
- Address
- 20119 VAN AKEN BLVD STE 211
- City
- Shaker Heights
- State
- Ohio
- ZIP Code
- 44122-3636
- Phone
- (216) 848-1420
Authorized Official
- Name
- DR. LISA DENISE BLACKMON, D.D.S.
- Title
- OWNER/DENTIST
- Phone
- (216) 848-1420
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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