Lawrence Burnett Blackmon, D.D.S.

NPI #1891907614 in Rancho Mirage, California

Provider Information

NPI Number: 1891907614
Entity Type: Individual
Name: Lawrence Burnett Blackmon, D.D.S.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist
Credential: D.D.S.
Enumeration Date: May 4, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 69730 HIGHWAY 111
Address 2: SUITE 105
City: Rancho Mirage
State: California
ZIP Code: 92270-2869
Phone: (760) 321-8869

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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