Individual provider · Type 1 NPI
Tyler Blackenburg
Periodontics · Bradenton, FL
NPI number
1164658977
Active
Practice location
8640 E State Road 70 # D
Bradenton, FL 34202-3785
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Periodontics Primary | 1223P0300X | DN17591 (FL) |
Periodontics: That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues.
2 other providers at this address
Other periodontics providers in Bradenton
About NPI 1164658977
Tyler Blackenburg's National Provider Identifier is 1164658977, issued on Jun 8, 2009. The primary taxonomy on file is Periodontics (1223P0300X), and the practice location is in Bradenton, FL. The record was last updated on Jun 8, 2009.