| Carter L Blevins Dmd | |
|
176 Southport Drive Somerset KY 42501-4149 | |
| (606) 679-7562 | |
| (606) 677-2557 |
| Full Name | Carter L Blevins Dmd |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 176 Southport Drive, Somerset, Kentucky |
| Authorized Official Name and Position | Carter L Blevins (OWNER ORAL SURGEON) |
| Authorized Official Contact | 6066797562 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Carter L Blevins Dmd 176 Southport Drive Somerset KY 42501-4149 Ph: (606) 679-7562 | Carter L Blevins Dmd 176 Southport Drive Somerset KY 42501-4149 Ph: (606) 679-7562 |
| NPI Number | 1073653853 |
|---|---|
| Provider Enumeration Date | 02/08/2007 |
| Last Update Date | 02/07/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073653853 | NPI | - | NPPES |
| 000000217071 | Other | KY | BCBS |
| 64042013 | Other | KY | MEDICAID MEDICAL |
| 60042017 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 4201 (Kentucky) | Primary |
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