THOMAS R BLAKE

FORT WAYNE, IN
NPI1669517330
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1223G0001X Dentist, General Practice
(Licence: IN  7973)
Enumeration Date2007-02-21
Last Update Date2007-07-09
Business Address
Dr. THOMAS R BLAKE DDS
2409 FAIROAK DR
FORT WAYNE, IN 46809-2301
Phone number: 260-747-5745
Mailing Address
Dr. THOMAS R BLAKE DDS
2409 FAIROAK DR
FORT WAYNE, IN 46809-2301
Phone number: 260-747-5745
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