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Organization
MELVYN A BLAKE DDS PC
Active
Organization
MELVYN A BLAKE DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MELVYN ARNOLD BLAKE DDS (OWNER)
(856) 596-1460
Entity
Organization
Contact information
Practice address
600 STATE HWY 73 NORTH, SUITE 9A, MARLTON, NJ 08053
(856) 596-1460
(856) 596-1085
Mailing address
600 STATE HWY 73 NORTH, SUITE 9A, MARLTON, NJ 08053
(856) 596-1460
(856) 596-1085
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
22DI00895300NJ
NJ
Other
Enumeration date
08/14/2006
Last updated
08/22/2020
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