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1285040394
BLAKE IMAM
MERIDIAN, ID
NPI
1285040394
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
122300000X Dentist
(Licence: ID D-4604)
Enumeration Date
2014-07-09
Last Update Date
2014-07-09
Business Address
-- BLAKE IMAM DMD
317 W CHERRY LN
MERIDIAN, ID 83642-1608
Phone number: 208-888-2055
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Mailing Address
-- BLAKE IMAM DMD
317 W CHERRY LN
MERIDIAN, ID 83642-1608
Phone number: 208-888-2055
Copy
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