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Individual

DR. JOHN P BLAKE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S., P.C.

Contact information

Practice address
1251 S LAPEER RD, SUITE 201, LAKE ORION, MI 48360-1414
(248) 693-5800
(248) 693-6383
Mailing address
1251 S LAPEER RD, SUITE 201, LAKE ORION, MI 48360-1414
(248) 693-5800
(248) 693-6383

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
16558
MI

Other

Enumeration date
10/24/2006
Last updated
07/08/2007
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