DR. Jason T Blackham, DMD
NPI #1437132537 in Travis Afb, California
Provider Information
- NPI Number
- 1437132537
- Entity Type
- Individual
- Name
- DR. Jason T Blackham, DMD
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Dentist - General Practice
- Credential
- DMD
- Enumeration Date
- Nov 22, 2005
- Last Updated
- Jan 31, 2020
Practice Location
- Address
- 60 MDG/SGIC
- Address 2
- 101 BODIN CIR
- City
- Travis Afb
- State
- California
- ZIP Code
- 94535-1800
- Phone
- (707) 423-7083
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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