Organization
H.C. BLAKE, III D.D.S. PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HENRY CHRISTOPHER BLAKE III D.D.S. (PRESIDENT)
(910) 762-8245
Entity
Organization
Contact information
Practice address
1802A NEW HANOVER MEDICAL PARK DR, WILMINGTON, NC 28403-5350
(910) 762-8245
(910) 763-2093
Mailing address
1802A NEW HANOVER MEDICAL PARK DR, WILMINGTON, NC 28403-5350
(910) 762-8245
(910) 763-2093
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
NC5127
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8990804
—
NC
Enumeration date
05/14/2007
Last updated
08/22/2020
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