Boleware, Blake Denton

Boleware, Blake Denton is an individual health care provider with primary practice located at 525 Thomastown Ln Ste A , Ridgeland MS 39157-3440. He recently has only one registered license in Dental Providers / Orthodontics and Dentofacial Orthopedics, which is considered as his primary health care specialty. Boleware, Blake Denton can be contacted via phone (601) 856-3054.

Contact Information

Primary practice address
525 Thomastown Ln Ste A Ridgeland MS 39157-3440
Phone: (601) 856-3054
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Orthodontics and Dentofacial Orthopedics 1223X0400X OR-575-20 Mississippi

Profile Details

NPI number 1881200673
LBN Legal business name Boleware, Blake Denton
Credentials DMD, MS
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 17th, 2020
Last updated Aug 14th, 2023 - about 2 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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