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Dr. Robert Edward Blake, DDS,MS
Orthodontics and Dentofacial Orthopedic Dentist in Fayetteville, Georgia
NPI 1407864440

Robert Edward Blake is a Orthodontics and Dentofacial Orthopedic Dentist based in Fayetteville, GA and is specialized in Orthodontics and Dentofacial Orthopedics. Robert Edward Blake practices in Fayetteville, GA and has the professional credentials of DDS,MS. The NPI Number for Robert Edward Blake is 1407864440 and holds a License No. 7991 (Georgia).

The current practice location address for Robert Edward Blake is 104 N Park Dr, Fayetteville, GA and can be reached out via phone at 770-461-9931 and via fax at 770-461-9176.

Location: 104 N Park Dr, Fayetteville, GA, 30214-1645
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1407864440
Provider Name
Robert Edward Blake
Credential
DDS,MS
Provider Entity Type
Individual
Gender
Male
Address
104 N Park Dr, Fayetteville, GA, 30214-1645
Phone Number
770-461-9931
Fax Number
770-461-9176
Provider Enumeration Date
08/04/2006
Last Update Date
03/08/2024
institution
Provider Business Practice Location Address Details
Address
104 N Park Dr
City
Fayetteville
State
Georgia
Zip
30214-1645
Phone Number
770-461-9931
Fax Number
770-461-9176
person
Provider Business Mailing Address Details
Address
104 N Park Dr
City
Fayetteville
State
Georgia
Zip
30214-1645
Phone Number
770-461-9931
Fax Number
770-461-9176
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Orthodontics and Dentofacial Orthopedics
Taxonomy
1223X0400X
License No.
7991 (Georgia)
Definition
That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures.
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