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1669517330
THOMAS R BLAKE
FORT WAYNE, IN
NPI
1669517330
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: IN 7973)
Enumeration Date
2007-02-21
Last Update Date
2007-07-09
Business Address
Dr. THOMAS R BLAKE DDS
2409 FAIROAK DR
FORT WAYNE, IN 46809-2301
Phone number: 260-747-5745
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Mailing Address
Dr. THOMAS R BLAKE DDS
2409 FAIROAK DR
FORT WAYNE, IN 46809-2301
Phone number: 260-747-5745
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