| NPI | 1730146291 |
|---|---|
| Former Legal Business Name | WILLIAM R BLACKMORE, DDS, P.C. |
| Entity Type | Organization |
| Authorized Contact | WILLIAM RAYMOND BLACKMORE President 928-474-5231 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ 3009) |
| Enumeration Date | 2006-04-27 |
| Last Update Date | 2010-11-08 |