Individual
DR. BLAKE WESTRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
903 18TH ST, CHARLESTON, IL 61920-2938
(217) 348-7770
(217) 348-9729
Mailing address
903 18TH ST, CHARLESTON, IL 61920-2938
(217) 348-7770
(217) 348-9729
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019.028066
IL
Other
Enumeration date
12/15/2009
Last updated
12/15/2009
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