James Rex Blalock, DDS Valid NPI

Individual provider · Dentist · Fontana, CA

NPI

1619197563

Type

Individual (Type 1)

Primary specialty

Dentist

Specialty group

Dental Providers

Taxonomy code

122300000X

License number

27104 DENTIST (CA)

Sex

Male

Sole proprietor

No

Enumerated

2007-04-25

Last updated

2007-07-08