Individual
DR. BLAKE CHRISTOPHER ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1112 BAXTER ST, NEOSHO, MO 64850-7814
(417) 451-2403
Mailing address
1551 HALE MCGINTY DR, NEOSHO, MO 64850-7814
(417) 434-1203
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2020021104
MO
Other
Enumeration date
07/14/2020
Last updated
07/14/2020
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