Richard W Blake Dds Pa

LBN: Richard W Blake Dds Pa
Richard W Blake Dds Pa is an health care organization with primary practice located at 943 Cesery Blvd Ste D , Jacksonville FL 32211-5655. The organization recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as the primary health care specialty. Richard W Blake Dds Pa can be contacted via phone (904) 743-2000, or through Blake, Richard Wayne via phone 19047432000.

Contact Information

Primary practice address
943 Cesery Blvd Ste D Jacksonville FL 32211-5655
Phone: (904) 743-2000
Fax: (904) 744-0598
Website:
Map and Directions
Authorized official contact:
Name: Blake, Richard Wayne Doctor of Dental Surgery (DDS)
Phone: 19047432000

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Pediatric Dentistry 1223P0221X 0005634 Florida

Profile Details

NPI number 1558701177
LBN Legal business name Richard W Blake Dds Pa
DBA Doing business as
Authorized official Blake, Richard Wayne Doctor of Dental Surgery (DDS)
Entity Organization
Organization subpart 1 No
Enumeration date Jun 27th, 2013
Last updated Jun 27th, 2013 - about 12 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558701177 NPPES
Florida MEDICAID 074223600

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