Provider Demographics
NPI:1568208007
Name:GARFINKEL, BLAKE CAMERON (DDS)
Entity type:Individual
Prefix:DR
First Name:BLAKE
Middle Name:CAMERON
Last Name:GARFINKEL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:351 VISTA OAK DR
Mailing Address - Street 2:
Mailing Address - City:LONGWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:32779-3069
Mailing Address - Country:US
Mailing Address - Phone:321-356-9184
Mailing Address - Fax:
Practice Address - Street 1:1970 GAINSBOROUGH DR STE 2
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32311-2717
Practice Address - Country:US
Practice Address - Phone:850-765-3040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-03
Last Update Date:2024-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL29024122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist