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Organization

J BLAKE, DMD, PS

Active
Other names
KidSmile Dental
Organization subpart
No

Provider details

NPI number
Authorized official
DR. T. JOEL BLAKE DMD (OWNER/DENTIST)
(509) 926-1234
Entity
Organization

Contact information

Practice address
12615 E MISSION AVE, SUITE 312, SPOKANE VALLEY, WA 99216-1047
(509) 926-1234
(509) 926-1701
Mailing address
12615 E MISSION AVE, SUITE 312, SPOKANE VALLEY, WA 99216-1047
(509) 926-1234
(509) 926-1701

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
10588
WA
1223P0221X
Pediatric Dentistry
Primary
9846
WA

Other

Enumeration date
07/20/2007
Last updated
03/31/2009
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