Dental Yellow Pages

Dental Yellow Pages

Dentists, Dental Clinics and Practices
Oral Surgery, Dental Specialists

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SCOTT M BLAKE DDS

Oral and Maxillofacial Pathology

Idaho Falls, Idaho

Provider NPI: 1376684175

Provider Information:
 SCOTT M BLAKE DDS
Gender: M
Not Sole Proprietor

Practice Location:
333 S WOODRUFF AVE  IDAHO FALLS, ID 83401 US
Tel: 208-523-2160  Fax: 208-552-8079

Business Mailing Address:
333 S WOODRUFF AVE  IDAHO FALLS, ID 83401 US
Tel: 208-523-2160  Fax: 208-552-8079

Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y1223P0106XDental Providers
Dentist
Oral and Maxillofacial Pathology
IDD3728

Other Provider Identifiers:

IssuerNumberStateType
REGENCE BLUE SHIELD000010143970ID01
806657300ID05
FEDERAL BLUE CROSS6I468ID01
118557800WY05
UNITED CONCORDIA1504752ID01
806720800ID05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin



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