Robert Reese Blackhurst, D.D.S. Valid NPI

Individual provider · General Practice Dentistry · Pleasant Grove, UT

NPI

1548475551

Type

Individual (Type 1)

Primary specialty

General Practice Dentistry (Dentist)

Specialty group

Dental Providers

Taxonomy code

1223G0001X

License number

359932-9922 (UT)

Sex

Male

Sole proprietor

No

Enumerated

2007-05-12

Last updated

2007-07-08