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Tyler Blackenburg
Periodontist in Bradenton, Florida
NPI 1164658977

Tyler Blackenburg is a Periodontist based in Bradenton, FL and is specialized in Periodontics. Tyler Blackenburg practices in Bradenton, FL. The NPI Number for Tyler Blackenburg is 1164658977 and holds a License No. DN17591 (Florida).

The current practice location address for Tyler Blackenburg is 8640 E State Road 70 # D, Bradenton, FL and can be reached out via phone at 941-756-3410.

Location: 8640 E State Road 70 # D, Bradenton, FL, 34202-3785
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1164658977
Provider Name
Tyler Blackenburg
Credential
Provider Entity Type
Individual
Gender
Male
Address
8640 E State Road 70 # D, Bradenton, FL, 34202-3785
Phone Number
941-756-3410
Fax Number
Provider Enumeration Date
06/08/2009
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
8640 E State Road 70 # D
City
Bradenton
State
Florida
Zip
34202-3785
Phone Number
941-756-3410
Fax Number
person
Provider Business Mailing Address Details
Address
8640 E State Road 70 # D
City
Bradenton
State
Florida
Zip
34202-3785
Phone Number
941-756-3410
Fax Number
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Periodontics
Taxonomy
1223P0300X
License No.
DN17591 (Florida)
Definition
That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues.
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