Dr Christopher Blake Sc | |
17280 W North Ave Suite #102 Brookfield WI 53045-4336 | |
(262) 789-9200 | |
(262) 789-9213 |
Full Name | Dr Christopher Blake Sc |
---|---|
Speciality | Dentist |
Location | 17280 W North Ave, Brookfield, Wisconsin |
Authorized Official Name and Position | Christopher Allen Blake (DENTIST PRESIDENT OF SERVICE CORPOR) |
Authorized Official Contact | 2627899200 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Dr Christopher Blake Sc 17280 W North Ave Suite #102 Brookfield WI 53045-4336 Ph: (262) 789-9200 | Dr Christopher Blake Sc 17280 W North Ave Suite #102 Brookfield WI 53045-4336 Ph: (262) 789-9200 |
NPI Number | 1386783488 |
---|---|
Provider Enumeration Date | 02/05/2007 |
Last Update Date | 10/27/2010 |
Identifier | Type | State | Issuer |
---|---|---|---|
1386783488 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | 5002097015 (Wisconsin) | Primary |
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