Dr Christopher Blake Sc

NPI #1386783488 in Brookfield, Wisconsin

Provider Information

NPI Number: 1386783488
Entity Type: Organization
Organization Name: Dr Christopher Blake Sc
Primary Specialty: Dentist
Enumeration Date: Feb 5, 2007
Last Updated: Oct 27, 2010

Practice Location

Address: 17280 W NORTH AVE
Address 2: SUITE #102
City: Brookfield
State: Wisconsin
ZIP Code: 53045-4336
Phone: (262) 789-9200

Authorized Official

Name: DR. CHRISTOPHER ALLEN BLAKE, DDS
Title: DENTIST PRESIDENT OF SERVICE CORPOR
Phone: (262) 789-9200

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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