Blake, Thomas Joel

Blake, Thomas Joel is an sole proprietor health care provider with primary practice located at 721 N Pines Rd Suite 101, Spokane Valley WA 99206-5225. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Blake, Thomas Joel can be contacted via phone (509) 926-1234.

Contact Information

Primary practice address
721 N Pines Rd Suite 101 Spokane Valley WA 99206-5225
Fax: (509) 926-1701
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X DE00010588 Washington
Dental Providers / General Practice 1223G0001X 5226914-9921 Utah
Dental Providers / General Practice 1223G0001X 5775 Arizona

Profile Details

NPI number 1992862593
LBN Legal business name Blake, Thomas Joel
Credentials D.D.S., M.S.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 2nd, 2007
Last updated Aug 30th, 2012 - about 14 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 1992862593 NPPES
Washington MEDICAID 5051255

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