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General NPI Number Information
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NPI Number | 1659243277
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Entity Type | Organization
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Legal Business Name | COURTNEY LAHATTE BLANKENSHIP DMD PLLC
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Dates
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Enumeration Date | 09/22/2025
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Last Update Date | 09/22/2025
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Provider Practice Location Address
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Address Line | 136 MLK JR BLVD
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City | BRISTOL
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State | TN
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Zip | 37620-3599
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Country | US
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Telephone | 423-989-7733
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Fax |
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Provider Business Mailing Address
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Address Line | 225 HIDDEN ACRES RD
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City | KINGSPORT
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State | TN
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Zip | 37664-5610
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/DENTIST
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Name | COURTNEY LAHATTE BLANKENSHIP
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Credential |
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Telephone | 678-315-2665
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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