Blake, Terry Michael
Blake, Terry Michael is an sole proprietor health care provider with primary practice located at 225 South Main Suite 101, O'Fallon MO 63366. He recently has only one registered license in Dental Providers / Orthodontics and Dentofacial Orthopedics, which is considered as his primary health care specialty. Blake, Terry Michael can be contacted via phone (636) 272-6666.Contact Information
Primary practice address
225 South Main Suite 101
O'Fallon MO 63366
Phone: (636) 272-6666
Fax: (636) 272-6661
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Orthodontics and Dentofacial Orthopedics | 1223X0400X | 011574 | Missouri |
Profile Details
| NPI number | 1003485624 |
|---|---|
| LBN Legal business name | Blake, Terry Michael |
| Credentials | DDS, MSD |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 18th, 2021 |
| Last updated | Jun 18th, 2021 - about 4 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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