Charlton Bryan Blakeney D.m.d.
NPI #1417352204 in Gulfport, Mississippi
Provider Information
- NPI Number
- 1417352204
- Entity Type
- Organization
- Organization Name
- Charlton Bryan Blakeney D.m.d.
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Oct 23, 2014
- Last Updated
- Oct 23, 2014
Practice Location
- Address
- 12182 HIGHWAY 49
- City
- Gulfport
- State
- Mississippi
- ZIP Code
- 39503-3125
- Phone
- (228) 832-4224
Authorized Official
- Name
- KAREN BLAKENEY
- Title
- OWNER
- Phone
- (228) 896-0019
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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