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NPI Code Detail

MEDICARE: DR. AARON CHRISTIAN BLACKWELDER DDS

MEDICARE:  DR. AARON CHRISTIAN BLACKWELDER  DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223P0221XPediatric Dentistry08436IA
21223P0221XPediatric Dentistry22764TX

General Provider Information

NPI Number : 1629296553
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. AARON CHRISTIAN BLACKWELDER DDS
Provider Business Mailing Address
First Line : 1121 LAKE AIR DR
Second Line :
City : WACO
State : TX
Zip : 76710-4417
Country : US
Telephone Number : 254-772-8330
Fax Number : 254-772-8496
Provider Business Practice Location Address
First Line : 1121 LAKE AIR DR
Second Line :
City : WACO
State : TX
Zip : 76710-4417
Country : US
Telephone Number : 254-772-8330
Fax Number : 254-772-8496
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/23/2007
Last Update Date : 11/02/2011

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Directions to “ DR. AARON CHRISTIAN BLACKWELDER DDS” Practice Location

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