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DR. DANIEL MILLER BLACKSHARE DDS
>> Dentist >> Dental ProvidersRegistrant NPI Number: 1144880154
Individual Registrant:DR. DANIEL MILLER BLACKSHARE DDS
Gender: M
Not Sole Proprietor
Gender: M
Not Sole Proprietor
Location and contact information for practice:
737 E 9TH ST RECTOR, AR 72461-2705 US
Tel: 870-595-3463 Fax: --
Tel: 870-595-3463 Fax: --
Contact information for business:
PO BOX 284 RECTOR, AR 72461-0284 US
Tel: 870-595-4220 Fax: --
Tel: 870-595-4220 Fax: --
Registration Information:
NPI: 1144880154
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 122300000X | Dental Providers Dentist | AR | 4366 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
