Blackham, Jason T

Blackham, Jason T is an individual health care provider with primary practice located at 60 Mdg/Sgic 101 Bodin Cir, Travis Afb CA 94535-1800. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Blackham, Jason T can be contacted via phone (707) 423-7083.

Contact Information

Primary practice address
60 Mdg/Sgic 101 Bodin Cir Travis Afb CA 94535-1800
Phone: (707) 423-7083
Fax: (707) 423-7117
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 264631-9922 Utah

Profile Details

NPI number 1437132537
LBN Legal business name Blackham, Jason T
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 22nd, 2005
Last updated Jan 31st, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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