Individual
DR. THOMAS JOEL BLAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S., M.S.D.
Contact information
Practice address
721 N PINES RD, SUITE 101, SPOKANE VALLEY, WA 99206-5225
(509) 926-1234
(509) 926-1701
Mailing address
721 N PINES RD, SUITE 101, SPOKANE VALLEY, WA 99206-5225
(509) 926-1234
(509) 926-1701
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
5226914-9921
UT
1223G0001X
General Practice Dentistry
5775
AZ
1223G0001X
General Practice Dentistry
Primary
DE00010588
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5051255
—
WA
Enumeration date
01/02/2007
Last updated
08/30/2012
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