Organization
DR CHRISTOPHER BLAKE SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHRISTOPHER ALLEN BLAKE DDS (DENTIST PRESIDENT OF SERVICE CORPOR)
(262) 789-9200
Entity
Organization
Contact information
Practice address
17280 W NORTH AVE, SUITE #102, BROOKFIELD, WI 53045-4336
(262) 789-9200
(262) 789-9213
Mailing address
17280 W NORTH AVE, SUITE #102, BROOKFIELD, WI 53045-4336
(262) 789-9200
(262) 789-9213
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5002097015
WI
Other
Enumeration date
02/05/2007
Last updated
10/27/2010
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