JASON T BLACKHAM

TRAVIS AFB, CA
NPI1437132537
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1223G0001X Dentist General Practice
(Licence: UT  264631-9922)
Enumeration Date2005-11-22
Last Update Date2020-01-31
Business Address
DR. JASON T BLACKHAM DMD
60 MDG/SGIC 101 BODIN CIR
TRAVIS AFB, CA 94535-1800
Phone number: 707-423-7083
Mailing Address
DR. JASON T BLACKHAM DMD
101 BODIN CIR
TRAVIS AFB, CA 94535-1809
Phone number: 707-423-7083
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