Organization
CLINTON L BLAKE DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CLINTON BLAKE DDS PC (DENTIST/OWNER)
(405) 392-4883
Entity
Organization
Contact information
Practice address
2820 NW 32ND ST, NEWCASTLE, OK 73065-6576
(405) 392-4883
(405) 392-4889
Mailing address
2820 NW 32ND ST, NEWCASTLE, OK 73065-6576
(405) 392-4883
(405) 392-4889
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6330
OK
Other
Enumeration date
09/13/2011
Last updated
09/13/2011
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