BLAKE EDWIN MOORE

FOLSOM, CA
NPI1801883756
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1223P0221X Dentist, Pediatric Dentistry
(Licence: CA  64252)
Enumeration Date2005-10-05
Last Update Date2019-12-25
Business Address
Dr. BLAKE EDWIN MOORE DDS
2190 E BIDWELL ST
FOLSOM, CA 95630-6453
Phone number: 916-984-0304
Mailing Address
Dr. BLAKE EDWIN MOORE DDS
2190 E BIDWELL ST
FOLSOM, CA 95630-6453
Phone number: 916-984-0304
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