Organization
BRANDON BLAKE DDS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRANDON JOSEPH BLAKE DDS (OWNER/DENTIST)
(828) 442-3206
Entity
Organization
Contact information
Practice address
122 HARDEES LN, BANNER ELK, NC 28604-9683
(828) 898-4656
Mailing address
122 HARDEES LN, BANNER ELK, NC 28604-9683
(828) 898-4656
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
8380
NC
Other
Enumeration date
01/10/2018
Last updated
01/10/2018
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