Organization
BLAKE FERANDO DMD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BLAKE ANTHONY FERANDO DMD (DOCTOR)
(636) 978-6400
Entity
Organization
Contact information
Practice address
346 FORT ZUMWALT SQ, O FALLON, MO 63366-3065
(636) 978-6400
Mailing address
346 FORT ZUMWALT SQ, O FALLON, MO 63366-3065
(636) 978-6400
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2018015357
MO
Other
Enumeration date
07/20/2018
Last updated
07/20/2018
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