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Individual
DR. THOMAS JOEL BLAKE
Active
Individual
DR. THOMAS JOEL BLAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S., M.S.D.
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
5226914-9921
UT
1223G0001X
General Practice Dentistry
5775
AZ
1223G0001X
General Practice Dentistry
Primary
DE00010588
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5051255
—
WA
Enumeration date
01/02/2007
Last updated
08/30/2012
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