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General NPI Number Information
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NPI Number | 1972732121
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Entity Type | Individual
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Provider Name | CHRISTIE BLECKLEY MCCARLEY D.M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/09/2009
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Last Update Date | 08/24/2012
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Provider Practice Location Address
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Address Line | 1120 15TH STREET
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City | AUGUSTA
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State | GA
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Zip | 30912
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Country | US
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Telephone | 706-721-2716
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Fax |
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Provider Business Mailing Address
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Address Line | 6295 HARLEM GROVETOWN RD.
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City | HARLEM
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State | GA
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Zip | 30814
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Country | US
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Telephone | 706-577-1854
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | DN013893
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License Number State | GA
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