Dickens, Blake Allen

Dickens, Blake Allen is an individual health care provider with primary practice located at 3817 Fairview Dr , Owensboro KY 42303-2117. He recently has 2 registered licenses in different health care specialties including Dental Providers / General Practice, Dental Providers / Pediatric Dentistry. Dental Providers / Pediatric Dentistry is his primary health care specialty. Dickens, Blake Allen can be contacted via phone (270) 993-4076.

Contact Information

Primary practice address
3817 Fairview Dr Owensboro KY 42303-2117
Phone: (270) 993-4076
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 30.025303 Ohio
Dental Providers / Pediatric Dentistry 1223P0221X 9952 Kentucky

Profile Details

NPI number 1154852697
LBN Legal business name Dickens, Blake Allen
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 26th, 2017
Last updated Feb 14th, 2023 - about last year

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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Identifiers

StateTypeNumberIssuer
All States NPI 1154852697 NPPES
Kentucky MEDICAID 7100568370

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