Individual provider · Type 1 NPI
Shane Kyle Blacker, DDS
Orthodontics and Dentofacial Orthopedics Dentistry · Tempe, AZ
Practice location
6200 S Mcclintock Dr Ste 11
Tempe, AZ 85283-3268
Fax (480) 839-1029
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry Primary | 1223X0400X | 6210 (AZ) |
Orthodontics and Dentofacial Orthopedics Dentistry: That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of funct…
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About NPI 1184892473
Shane Kyle Blacker, DDS's National Provider Identifier is 1184892473, issued on Feb 20, 2008. The primary taxonomy on file is Orthodontics and Dentofacial Orthopedics Dentistry (1223X0400X), and the practice location is in Tempe, AZ. The record was last updated on Feb 20, 2008.