Provider Demographics
NPI:1346655057
Name:BLANKENSHIP, MARION CATHARINE (DDS)
Entity Type:Individual
Prefix:
First Name:MARION
Middle Name:CATHARINE
Last Name:BLANKENSHIP
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 97
Mailing Address - Street 2:
Mailing Address - City:BAKER
Mailing Address - State:WV
Mailing Address - Zip Code:26801-0097
Mailing Address - Country:US
Mailing Address - Phone:304-897-5915
Mailing Address - Fax:304-897-6216
Practice Address - Street 1:65 HOSPITAL DR
Practice Address - Street 2:SUITE 5
Practice Address - City:PETERSBURG
Practice Address - State:WV
Practice Address - Zip Code:26847-9549
Practice Address - Country:US
Practice Address - Phone:304-257-4593
Practice Address - Fax:304-530-5160
Is Sole Proprietor?:No
Enumeration Date:2014-06-23
Last Update Date:2014-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV4113122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist