Blankenship, Bryan Keith

Blankenship, Bryan Keith is an individual health care provider with primary practice located at 25 Pine Cone Dr Ste 1 , Palm Coast FL 32164-8424. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Blankenship, Bryan Keith can be contacted via phone (386) 445-7671.

Contact Information

Primary practice address
25 Pine Cone Dr Ste 1 Palm Coast FL 32164-8424
Phone: (386) 445-7671
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 16941 Florida

Profile Details

NPI number 1750481131
LBN Legal business name Blankenship, Bryan Keith
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 25th, 2006
Last updated Dec 4th, 2020 - about 5 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1750481131 NPPES
Florida Other 203294786 TAX IDENTIFICATION NUMBER

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