Dr. Michael Martin Blackmon, DR DDS
Dentist, General Practice in Calhoun, GA. Individual provider (NPI-1).
NPI number1962575290
StatusActive
Last updated in NPPESAug 17, 2022
Details
- NPI
- 1962575290
- Entity type
- Individual (NPI-1)
- Name
- Dr. Michael Martin Blackmon
- Credential
- DR DDS
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Nov 16, 2006
- Certification date
- Aug 17, 2022
- Last updated
- Aug 17, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | DN011797 | GA | Yes |
Practice location
705 Red Bud Rd Ne Ste ACalhoun, GA 30701-1966
Phone 762-538-2095 · Fax 762-538-2097
Mailing address
7 Farm View Ct NwRome, GA 30165-2679
Phone 706-346-6793
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