Individual
MR. BLAKE K TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2095 W FRYE RD, SUITE 2, CHANDLER, AZ 85224
(480) 855-8315
(480) 855-8316
Mailing address
2095 W FRYE RD, SUITE 2, CHANDLER, AZ 85224
(480) 855-8315
(480) 855-8316
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6951
AZ
Other
Enumeration date
12/28/2006
Last updated
01/17/2018
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