Individual
DR. BLAKE CHRISTOPHER PUTMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
11110 FORT ST STE 106, OMAHA, NE 68164-2183
(217) 691-7848
Mailing address
832 COVENTRY PT, SPRINGFIELD, IL 62702-3389
(217) 691-7848
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DDS-10153
IA
Other
Enumeration date
06/12/2023
Last updated
08/21/2023
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