BLAKE IMAM

MERIDIAN, ID
NPI1285040394
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy122300000X Dentist
(Licence: ID  D-4604)
Enumeration Date2014-07-09
Last Update Date2014-07-09
Business Address
-- BLAKE IMAM DMD
317 W CHERRY LN
MERIDIAN, ID 83642-1608
Phone number: 208-888-2055
Mailing Address
-- BLAKE IMAM DMD
317 W CHERRY LN
MERIDIAN, ID 83642-1608
Phone number: 208-888-2055
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