Individual
DR. CHRISTOPHER ALLEN BLAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
17280 W NORTH AVE, SUITE 102, BROOKFIELD, WI 53045-4366
(262) 789-9200
(262) 789-9213
Mailing address
17280 W NORTH AVE, SUITE 102, BROOKFIELD, WI 53045-4366
(262) 789-9200
(262) 789-9213
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5002097015
WI
Other
Enumeration date
10/27/2010
Last updated
10/27/2010
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