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Individual

DR. BLAKE JUDE VIDRINE II

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
10330 AIRLINE HWY STE A6, BATON ROUGE, LA 70816-4191
(225) 308-8000
(225) 308-8000
Mailing address
132 CYPRESS DR, CROWLEY, LA 70526-2008
(337) 581-5791

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7227
LA
1223G0001X
General Practice Dentistry
D-0006879-C1
AL

Other

Enumeration date
05/29/2021
Last updated
05/04/2023
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