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Dr. Richard Wayne Blake, DDSPA
Pediatric Dentist in Clearwater, Florida
NPI 1912921867

Richard Wayne Blake is a Pediatric Dentist based in Clearwater, FL and is specialized in Pediatric Dentistry. Richard Wayne Blake practices in Clearwater, FL and has the professional credentials of DDSPA. The NPI Number for Richard Wayne Blake is 1912921867 and holds a License No. 0005634 (Florida).

The current practice location address for Richard Wayne Blake is 2701 Park Dr, Clearwater, FL and can be reached out via phone at 727-796-2187 and via fax at 727-791-7660.

Location: 2701 Park Dr, Clearwater, FL, 33763-1021
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1912921867
Provider Name
Richard Wayne Blake
Credential
DDSPA
Provider Entity Type
Individual
Gender
Male
Address
2701 Park Dr, Clearwater, FL, 33763-1021
Phone Number
727-796-2187
Fax Number
727-791-7660
Provider Enumeration Date
07/26/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
074223600 05 FL
institution
Provider Business Practice Location Address Details
Address
2701 Park Dr
City
Clearwater
State
Florida
Zip
33763-1021
Phone Number
727-796-2187
Fax Number
727-791-7660
person
Provider Business Mailing Address Details
Address
2701 Park Dr
City
Clearwater
State
Florida
Zip
33763-1021
Phone Number
727-796-2187
Fax Number
727-791-7660
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Pediatric Dentistry
Taxonomy
1223P0221X
License No.
0005634 (Florida)
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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