Individual provider · Type 1 NPI
Terry Michael Blake, DDS, MSD
Orthodontics and Dentofacial Orthopedics Dentistry · O'fallon, MO
Practice location
225 South Main, Suite 101
O'fallon, MO 63366
Fax (636) 272-6661
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry Primary | 1223X0400X | 011574 (MO) |
Orthodontics and Dentofacial Orthopedics Dentistry: That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of funct…
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About NPI 1003485624
Terry Michael Blake, DDS, MSD's National Provider Identifier is 1003485624, issued on Jun 18, 2021. The primary taxonomy on file is Orthodontics and Dentofacial Orthopedics Dentistry (1223X0400X), and the practice location is in O'fallon, MO. The record was last updated on Jun 18, 2021.