Individual provider · Type 1 NPI
Evan Blackwell, DDS
Periodontics · Pflugerville, TX
NPI number
1588072987
Active
Practice location
2911 A W Grimes Blvd Ste 106
Pflugerville, TX 78660-5459
Mailing address
10430 Morado Cir Apt 2030
Austin, TX 78759-5669
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dentist | 122300000X | 32883 (TX) |
| Dentist | 122300000X | D10343 (OR) |
| Periodontics Primary | 1223P0300X | 32883 (TX) |
| Student in an Organized Health Care Education/Training Program | 390200000X | None listed |
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.
About NPI 1588072987
Evan Blackwell, DDS's National Provider Identifier is 1588072987, issued on Jul 29, 2014. The primary taxonomy on file is Periodontics (1223P0300X), and the practice location is in Pflugerville, TX. The record was last updated on Jul 27, 2023.