Tyler Blackenburg
Tyler Blackenburg is a Periodontics in Bradenton, Florida. Licensed in Florida. Registered with an NPI since 2009.
- Licensed in
- FL
- In the registry since
- 2009
Practice location Address checks out
8640 E State Road 70 # DBradenton, FL 34202-3785
Phone: (941) 756-3410
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Periodontics (primary) | Taxonomy 1223P0300X · Licence DN17591 (FL) |
|---|
Record details
| NPI number | 1164658977 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | No |
| NPI enumerated | June 8, 2009 |
| Last updated in NPPES | June 8, 2009 |
| Mailing address | 8640 E State Road 70 # D, Bradenton, FL 34202-3785 |
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