Individual
DR. BLAKE THOMAS PRATHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
112 E ALTO RD, KOKOMO, IN 46902-3601
(765) 455-2505
(765) 455-2564
Mailing address
112 E ALTO RD, KOKOMO, IN 46902-3601
(765) 455-2505
(765) 455-2564
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12011651A
IN
Other
Enumeration date
06/14/2011
Last updated
06/26/2014
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