Blackstockdentalcorp is a Dental Clinic in Lakeside, California. It is located at 12110 Woodside Ave, Lakeside, CA and its contact number is 619-443-0444. The authorized person for Blackstockdentalcorp is Burch Lee Blackstock
who is Dentist of the clinic and their contact number is 619-443-0444. The primary license number for Blackstockdentalcorp is 42123 (General Practice) in California.
Blackstockdentalcorp Clinic caters to patients of all ages for their dental care needs. Dentists at the clinic are responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
Complete Clinic Profile:
Blackstockdentalcorp Clinic speciality, address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointments.
| Name: | Blackstockdentalcorp |
| Specialization: | General Practice Dentistry |
| Clinic Address: | 12110 Woodside Ave, Lakeside,
California, 92040-3012 |
| Phone: | 619-443-0444 |
| Fax: | 619-443-0050 |
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints for this clinic are as below. Person's position and contact details are also mentioned below.
| Name: | Burch Lee Blackstock |
| Position: | Dentist |
| Contact Number: | 619-443-0444 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details for Blackstockdentalcorp clinic are as mentioned below.
| NPI Number: | 1417168881 |
| NPI Enumeration Date: | 25 May, 2007 |
| NPI Last Update On: | 10 Feb, 2016 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Blackstockdentalcorp are as mentioned below.
| Specialization | License Number | State | Status | |
| General Practice | 42123 | California | Primary | |
Other Medical Identifiers:
Other legacy medical identifiers of the clinic such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 42123 | Other | California | Dental Board |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | Blackstockdentalcorp
12110 Woodside Ave.,
Lakeside, California |
| Zip: | 92040-3012 |
| Phone Number: | 619-443-0444 |
| Fax Number: | 619-443-0050 |
Patients can reach Blackstockdentalcorp at
12110 Woodside Ave, Lakeside, California or can
call to book an appointment on 619-443-0444.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on
08 December, 2025.