Blake Imam, DMD
NPI 1285040394 · on the registry since 2014
Practice
- Address
- 317 W Cherry Ln
Meridian, ID 83642 - Phone
- (208) 888-2055
- Fax
- (208) 395-1017
- Organisation at this address
- Willow Tree Dental Pllc
Willow Tree Dental Group Llc
Willowtree Dental Group PllcInferred from a shared address, not stated in the registry. - Clinicians at this address
- 9
Registry record
- Primary taxonomy
- Dentist
122300000X
- Licence states on file
- ID
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2014-07-09
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Idaho