Individual
DR. BLAKE R. HENRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S., M.S.D.
Contact information
Practice address
7705 E 81ST ST, TULSA, OK 74133-4200
(918) 294-7705
Mailing address
7705 E 81ST ST, TULSA, OK 74133-4200
(918) 294-7705
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
ORTHODONTIST #152
OK
Other
Enumeration date
11/13/2006
Last updated
07/08/2007
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