Scott M. Blake, Dds, PC
NPI #1972779916 in Idaho Falls, Idaho
Provider Information
- NPI Number
- 1972779916
- Entity Type
- Organization
- Organization Name
- Scott M. Blake, Dds, PC
- Primary Specialty
- Dentist - Oral and Maxillofacial Surgery
- Enumeration Date
- Apr 30, 2008
- Last Updated
- Apr 30, 2008
Practice Location
- Address
- 333 S WOODRUFF AVE
- City
- Idaho Falls
- State
- Idaho
- ZIP Code
- 83401-4322
- Phone
- (208) 523-2160
Authorized Official
- Name
- ELAINE SCHMIDT
- Title
- RECEPTIONIST
- Phone
- (208) 523-2160
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - Oral and Maxillofacial Surgery — Oral and Maxillofacial Surgery |
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