NPI 1003963174 · live from the CMS NPI Registry
Marta Blackhurst, DDS.
Dentist, General Practice in Wilmington, DE. National Provider Identifier 1003963174, active.
NPI record
| NPI | 1003963174 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dentist, General Practice 1223G0001X |
| Practice location | 3522 Silverside Rd, The Commons #29, Wilmington, DE 19810 |
| Practice phone | 302-478-1504 |
| Enumerated | January 4, 2007 |
| Last updated | July 8, 2007 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dentist, General Practice primary | 1223G0001X | G10001061 (DE) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.