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Burch Lee Blackstock, DDS
General Practice Dentistry in Lakeside, California
NPI 1144387234

Burch Lee Blackstock is a General Practice Dentistry based in Lakeside, CA and is specialized in General Practice. Burch Lee Blackstock practices in Lakeside, CA and has the professional credentials of DDS. The NPI Number for Burch Lee Blackstock is 1144387234 and holds a License No. 42123 (California).

The current practice location address for Burch Lee Blackstock is 12110 Woodside Ave, Lakeside, CA and can be reached out via phone at 619-443-0444 and via fax at 619-443-0050.

Location: 12110 Woodside Ave, Lakeside, CA, 92040-3012
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1144387234
Provider Name
Burch Lee Blackstock
Credential
DDS
Provider Entity Type
Individual
Gender
Male
Address
12110 Woodside Ave, Lakeside, CA, 92040-3012
Phone Number
619-443-0444
Fax Number
619-443-0050
Provider Enumeration Date
01/02/2007
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
42123 01 CA DENTAL BOARD
institution
Provider Business Practice Location Address Details
Address
12110 Woodside Ave
City
Lakeside
State
California
Zip
92040-3012
Phone Number
619-443-0444
Fax Number
619-443-0050
person
Provider Business Mailing Address Details
Address
12110 Woodside Ave
City
Lakeside
State
California
Zip
92040-3012
Phone Number
619-443-0444
Fax Number
619-443-0050
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
General Practice
Taxonomy
1223G0001X
License No.
42123 (California)
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
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