Organization · Type 2 NPI

Scott M. Blake, Dds, PC

Oral and Maxillofacial Surgery (Dentist) · Idaho Falls, ID

NPI number 1972779916 Active

Practice location

333 S Woodruff Ave
Idaho Falls, ID 83401-4322

Specialties and licenses

TaxonomyCodeLicense
Oral and Maxillofacial Surgery (Dentist) Primary 1223S0112XD3728 (ID)

Oral and Maxillofacial Surgery (Dentist): The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.

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About NPI 1972779916

Scott M. Blake, Dds, PC's National Provider Identifier is 1972779916, issued on Apr 30, 2008. The primary taxonomy on file is Oral and Maxillofacial Surgery (Dentist) (1223S0112X), and the practice location is in Idaho Falls, ID. The record was last updated on Apr 30, 2008.