Provider Demographics
NPI:1689462749
Name:BLACKSHEAR FAMILY DENTISTRY LLC
Entity type:Organization
Organization Name:BLACKSHEAR FAMILY DENTISTRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATION MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SAVANNAH
Authorized Official - Middle Name:
Authorized Official - Last Name:SPIRES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:912-207-0223
Mailing Address - Street 1:618 E CARTER AVE
Mailing Address - Street 2:
Mailing Address - City:BLACKSHEAR
Mailing Address - State:GA
Mailing Address - Zip Code:31516-1559
Mailing Address - Country:US
Mailing Address - Phone:912-449-3300
Mailing Address - Fax:
Practice Address - Street 1:618 E CARTER AVE
Practice Address - Street 2:
Practice Address - City:BLACKSHEAR
Practice Address - State:GA
Practice Address - Zip Code:31516-1559
Practice Address - Country:US
Practice Address - Phone:912-449-3300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-29
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental