Dr Terry Michael Blake, DDS, MSD is a
Dentist - Orthodontics And Dentofacial Orthopedics based in O'fallon, Missouri. Dr Terry Michael Blake is licensed to practice in Missouri (license number 011574) and his current practice location is
225 South Main, Suite 101, O'fallon, Missouri. He can be reached at his office (for appointments etc.) via phone at
(636) 272-6666.
NPI number for Dr Terry Michael Blake is 1003485624 and his current mailing address is 225 South Main, Suite 101, O'fallon, Missouri. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1003485624.
Healthcare Provider's Profile
| Full Name | Dr Terry Michael Blake |
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| Gender | Male |
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| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
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| Location | 225 South Main, O'fallon, Missouri |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1003485624
- Provider Enumeration Date: 06/18/2021
- Last Update Date: 06/18/2021
Medical Identifiers
Medical identifiers for Dr Terry Michael Blake such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1003485624 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 011574 (Missouri) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Terry Michael Blake is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Terry Michael Blake, DDS, MSD
225 South Main, Suite 101,
O'fallon, MO 63366
Ph: (636) 272-6666 | Dr Terry Michael Blake, DDS, MSD
225 South Main, Suite 101,
O'fallon, MO 63366
Ph: (636) 272-6666 |
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