Michael Martin Blackmon, DR DDS
Individual provider Active NPI General Practice Dentistry · Calhoun, GA
NPI 1962575290 · NPPES record last updated Aug 17, 2022
Key facts
- NPI
- 1962575290
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- DN011797 (GA)
- Practice address
- 705 Red Bud Rd NE Ste a
Calhoun, GA 30701-1966 - Phone
- (762) 538-2095
- Fax
- (762) 538-2097
- NPI assigned
- Nov 16, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN011797 | GA | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DN011797 | GA | Yes |
Addresses
Primary practice location
705 Red Bud Rd NE Ste a
Calhoun, GA 30701-1966
Mailing address
7 Farm View CT NW
Rome, GA 30165-2679
Phone (706) 346-6793
Other providers in Calhoun, GA
- Carl Billian
- Bio-Medical Applications of Georgia, Inc.
- Bio-Medical Applications of Georgia, Inc.
- Joseph A Bishop
- Teresa Louise Bishop
- Terrilyn Lamb Blackstock
- John L Bledsoe
- Logan Blevins
- Lois Rebecca Blockley
- Hali Bohannon-Burns
All providers in Calhoun, GA · General Practice Dentistry in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 17, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.