Blalock, John S.
Blalock, John S. is an sole proprietor health care provider with primary practice located at 3606 Wheeler Rd. , Augusta GA 30909. He recently has 2 registered licenses in different health care specialties including Dental Providers / Dentist, Dental Providers / General Practice. Dental Providers / General Practice is his primary health care specialty. Blalock, John S. can be contacted via phone (706) 481-8811.Contact Information
Primary practice address
3606 Wheeler Rd.
Augusta GA 30909
Phone: (706) 481-8811
Fax: (706) 481-8507
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | DN011681 | Georgia |
| Dental Providers / General Practice | 1223G0001X | DN011681 | Georgia |
Profile Details
| NPI number | 1003862731 |
|---|---|
| LBN Legal business name | Blalock, John S. |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 25th, 2006 |
| Last updated | Oct 26th, 2017 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1003862731 | NPPES |
| South Carolina | MEDICAID | ZG1681 | |
| South Carolina | MEDICAID | 000879095A |
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