Individual
BLAKE BEAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1600 HWY 287 N. FRONTAGE RD, SUITE 102, MANSFIELD, TX 76063
(817) 473-9501
Mailing address
2975 BLACKBURN ST APT 2116, DALLAS, TX 75204-3842
(214) 454-0391
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
37249
TX
Other
Enumeration date
06/29/2021
Last updated
06/29/2021
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