Apostle, Gregory Blake

Apostle, Gregory Blake is an individual health care provider with primary practice located at 95 Montgomery Dr #210, Santa Rosa CA 95404. He recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as his primary health care specialty. Apostle, Gregory Blake can be contacted via phone (707) 542-4746.

Contact Information

Primary practice address
95 Montgomery Dr #210 Santa Rosa CA 95404
Phone: (707) 542-4746
Fax: (707) 544-7041
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Pediatric Dentistry 1223P0221X 42114 California

Profile Details

NPI number 1164526521
LBN Legal business name Apostle, Gregory Blake
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 7th, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1164526521 NPPES
California Other 42114 DENTAL LIC NUMBER

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