Scott M Blake, DDS

NPI #1376684175 in Idaho Falls, Idaho

Provider Information

NPI Number: 1376684175
Entity Type: Individual
Name: Scott M Blake, DDS
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist - Oral and Maxillofacial Pathology
Credential: DDS
Enumeration Date: Feb 12, 2007
Last Updated: Oct 15, 2015

Practice Location

Address: 333 S WOODRUFF AVE
City: Idaho Falls
State: Idaho
ZIP Code: 83401-4322
Phone: (208) 523-2160

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - Oral and Maxillofacial Pathology — Oral and Maxillofacial Pathology	1223P0106X	Primary

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Organizations

Provider Name	Specialty	City
Idaho Oral & Maxillofacial Surgery, PC	Dentist - Oral and Maxillofacial Pathology	Twin Falls	AI Deep Dive
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