Blake, Robert Edward
Blake, Robert Edward is an sole proprietor health care provider with primary practice located at 104 N Park Dr , Fayetteville GA 30214-1645. He recently has only one registered license in Dental Providers / Orthodontics and Dentofacial Orthopedics, which is considered as his primary health care specialty. Blake, Robert Edward can be contacted via phone (770) 461-9931.Contact Information
Primary practice address
104 N Park Dr
Fayetteville GA 30214-1645
Phone: (770) 461-9931
Fax: (770) 461-9176
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Orthodontics and Dentofacial Orthopedics | 1223X0400X | 7991 | Georgia |
Profile Details
| NPI number | 1407864440 |
|---|---|
| LBN Legal business name | Blake, Robert Edward |
| Credentials | D.D.S.,M.S. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 4th, 2006 |
| Last updated | Jul 8th, 2007 - about 18 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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