Individual
DR. BLAKE J EDINGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
15397 STATE HIGHWAY 32, LAKEWOOD, WI 54138
(715) 276-6321
Mailing address
15954 RIVERS EDGE DR STE 304, HAYWARD, WI 54843-7894
(715) 634-2541
(715) 634-2541
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
3874
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100065650
—
WI
Enumeration date
09/14/2005
Last updated
10/28/2018
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