Individual
DR. BLAKE DONALD THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
105 E DONALD ST, QUITMAN, MS 39355-2342
(601) 776-2511
(601) 776-8993
Mailing address
105 E DONALD ST, QUITMAN, MS 39355-2342
(601) 776-2511
(601) 776-8993
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2637-37
MS
Other
Enumeration date
08/09/2006
Last updated
07/21/2022
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