Blake Edwin Moore in Folsom - Pediatric Dentistry
Blake Edwin Moore - NPI 1801883756
Blake Edwin Moore is a Pediatric Dentistry in Folsom, California. Blake Edwin Moore practices all healthcare services and medical treatments related to Pediatric Dentistry. The NPI Number for Blake Edwin Moore is 1801883756. The last update date is 2019-12-25.
Blake Edwin Moore's current location address is 2190 E Bidwell St, Folsom, California. You can contact this provider via phone number 9169840304. The mailing address for Blake Edwin Moore is 2190 E Bidwell St, Folsom, California. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Blake Edwin Moore |
|---|---|
| Address | 2190 E Bidwell St, Folsom, California |
| Phone Number | 9169840304 |
| Fax Number | |
| Sole Proprietor | Y |
| Credentials | DDS |
NPI Number Detail
| NPI Number | 1801883756 |
|---|---|
| Provider Enumeration Date | 2005-10-05 |
| Last Updated Date | 2019-12-25 |
Provider Mailing Address Detail
| Address | 2190 E Bidwell St |
|---|---|
| City | Folsom |
| State | California (CA) |
| Post Code | 956306453 |
| Phone Number | 9169840304 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Pediatric Dentistry |
|---|---|
| Taxonomy | 1223P0221X |
| Licence No | 64252 |
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Definition: An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
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What is the unique 10-digit identifier code assigned to Blake Edwin Moore by the Centers for Medicare & Medicaid Services?
The Blake Edwin Moore has been issued the NPI (National Provider Identifier) 1801883756 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Could you provide the complete address where Blake Edwin Moore is physically located?
The Blake Edwin Moore is situated at the following address: 2190 E Bidwell St, Folsom, CA 956306453.
What is Blake Edwin Moore's specialized field of practice, and what is the corresponding taxonomy classification code?
The Blake Edwin Moore's area of specialization is Pediatric Dentistry, and the corresponding taxonomy code that categorizes this field of practice is 1223P0221X.
On what date did the Blake Edwin Moore receive the assignment of its 1801883756 from the Centers for Medicare & Medicaid Services?
The Blake Edwin Moore was issued its 1801883756 by the Centers for Medicare & Medicaid Services on 2005-10-05.
As of what date were the Blake Edwin Moore's details last updated?
The information pertaining to the Blake Edwin Moore, including its address, specialty, and other details, was most recently updated on 2019-12-25.
NPI Number: 1528061710
Address: 19 Nh Route 104, Meredith, NH