Organization
ALAN M. BLAKE D.D.S.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALAN M. BLAKE D.D.S. (OWNER/PRESIDENT)
(712) 362-5454
Entity
Organization
Contact information
Practice address
808 N. 9TH ST., ESTHERVILLE, IA 51334
(712) 362-5454
(712) 362-4737
Mailing address
808 N. 9TH ST., ESTHERVILLE, IA 51334
(712) 362-5454
(712) 362-4737
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
06008
IA
Other
Enumeration date
09/15/2009
Last updated
09/15/2009
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