Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Blackstockdentalcorp

Organization General Practice Dentistry · NPI 1417168881

Blackstockdentalcorp is a General Practice Dentistry in Lakeside, California. Licensed in California. Registered with an NPI since 2007.

Licensed in
CA
In the registry since
2007

Practice location Address checks out

12110 Woodside Ave
Lakeside, CA 92040-3012
Phone: (619) 443-0444
Fax: (619) 443-0050
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X · Licence 42123 (CA)

Record details

NPI number1417168881
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Burch Blackstock — Dentist · (619) 443-0444
NPI enumeratedMay 25, 2007
Last updated in NPPESFebruary 10, 2016
Mailing address12110 Woodside Ave., Lakeside, CA 92040-3012

Other providers in Lakeside