Gregory Blake Apostle in Santa Rosa - Pediatric Dentistry
Gregory Blake Apostle - NPI 1164526521
Gregory Blake Apostle is a Pediatric Dentistry in Santa Rosa, California. Gregory Blake Apostle practices all healthcare services and medical treatments related to Pediatric Dentistry. The NPI Number for Gregory Blake Apostle is 1164526521. The last update date is 2007-07-08.
Gregory Blake Apostle's current location address is 95 Montgomery Dr, Santa Rosa, California. You can contact this provider via phone number 7075424746 and fax number 7075447041. The mailing address for Gregory Blake Apostle is 95 Montgomery Dr, Santa Rosa, California. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Gregory Blake Apostle |
|---|---|
| Address | 95 Montgomery Dr, Santa Rosa, California |
| Phone Number | 7075424746 |
| Fax Number | 7075447041 |
| Sole Proprietor | N |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1164526521 |
|---|---|
| Provider Enumeration Date | 2006-09-07 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 95 Montgomery Dr |
|---|---|
| City | Santa Rosa |
| State | California (CA) |
| Post Code | 95404 |
| Phone Number | 7075424746 |
| Fax Number | 7075447041 |
Provider's Primary Taxonomy Detail
| Speciality | Pediatric Dentistry |
|---|---|
| Taxonomy | 1223P0221X |
| Licence No | 42114 |
|
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. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 42114 | CA | DENTAL LIC NUMBER |
Post Comment/ Review Below
What is the unique 10-digit identifier code assigned to Gregory Blake Apostle by the Centers for Medicare & Medicaid Services?
The Gregory Blake Apostle has been issued the NPI (National Provider Identifier) 1164526521 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Could you please share the complete physical address where Gregory Blake Apostle is geographically located?
The Gregory Blake Apostle is physically situated at the following location: 95 Montgomery Dr, Santa Rosa, CA, 95404.
What is Gregory Blake Apostle's specialized field of practice, and what is the corresponding taxonomy classification code?
The Gregory Blake Apostle'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 Gregory Blake Apostle receive the assignment of its 1164526521 from the Centers for Medicare & Medicaid Services?
The Gregory Blake Apostle was issued its 1164526521 by the Centers for Medicare & Medicaid Services on 2006-09-07.
When was the information regarding Gregory Blake Apostle most recently updated?
The details pertaining to the Gregory Blake Apostle, including its address, specialty, and other relevant information, were last refreshed on 2007-07-08.
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