BEAU D BLANKENSHIP DDS PC NPI 1104190594

NPI Information

BEAU D BLANKENSHIP, DDS, PC is a general practice dentist in Cedar Park, TX. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. BEAU D BLANKENSHIP, DDS, PC NPI is 1104190594. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Lakeline Mall Family Dental.

The provider's business location address is:

11200 LAKELINE MALL DR
#B1
CEDAR PARK, TX
ZIP 78613-501
Phone: (512) 448-4867
Fax: (512) 335-7668

The provider's authorized official is Beau D Blankenship .
The authorized official title is Owner/president and has the following contact phone number (210) 722-9274.

The enumeration date for this NPI number is 3/1/2012 and was last updated on 3/1/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

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