Blake, Ryan

Blake, Ryan is an individual health care provider with primary practice located at 4425 S. Mountain Road Ste 109, Mesa AZ 85212. He recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Dental Providers / Pediatric Dentistry. Dental Providers / Pediatric Dentistry is his primary health care specialty. Blake, Ryan can be contacted via phone (480) 676-1517.

Contact Information

Primary practice address
4425 S. Mountain Road Ste 109 Mesa AZ 85212
Phone: (480) 676-1517
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Dental Providers / Pediatric Dentistry 1223P0221X 10161 Arizona
Dental Providers / Pediatric Dentistry 1223P0221X 60796314 Washington

Profile Details

NPI number 1861841918
LBN Legal business name Blake, Ryan
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 9th, 2016
Last updated Oct 23rd, 2018 - about 8 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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