| Dr Derek Reade Blackwelder, DMD | |
|
944 Laconia Road, Winnisquam, NH 03289 | |
| (603) 528-1212 | |
| (603) 528-1320 |
| Full Name | Dr Derek Reade Blackwelder |
|---|---|
| Gender | Male |
| Speciality | Dentist |
| Location | 944 Laconia Road, Winnisquam, New Hampshire |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568459956 | NPI | - | NPPES |
| 24636371 | Medicaid | NM | |
| 3070586 | Medicaid | NH | |
| 945719 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 03600 (New Hampshire) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Derek Reade Blackwelder, DMD Po Box 1020, Winnisquam, NH 03289-1020 Ph: (603) 528-1212 | Dr Derek Reade Blackwelder, DMD 944 Laconia Road, Winnisquam, NH 03289 Ph: (603) 528-1212 |
Dr. Kristine Ep Blackwelder, DMD Dentist Medicare: Not Enrolled in Medicare Practice Location: 944 Laconia Road, Winnisquam, NH 03289 Phone: 603-528-1212 Fax: 603-528-1320 | |
Dr. Jared Knighton, DMD Dentist Medicare: Not Enrolled in Medicare Practice Location: 944 Laconia Rd, Winnisquam, NH 03289 Phone: 603-528-1212 |