Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. BLAKE BORELLO, D.D.S., M.S.
ActiveDR. BLAKE BORELLO, D.D.S., M.S. is a Orthodontics healthcare provider located in LAKE SAINT LOUIS, Missouri. NPI 1902114515 is currently active in the NPPES registry. Verify at CMS.
Orthodontics · LAKE SAINT LOUIS, MO
Registration Details
- NPI Number
- 1902114515
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Sep 16, 2010 (15.865543499641 yrs)
- Last Updated
- Feb 2, 2011
- License
-
2008019644 (MO)
Practice Information
- Address
-
6288 RONALD REAGAN DR.LAKE SAINT LOUIS, MO, 63367Browse MO providers · Browse ZIP 63367
- Phone
- 6366254224
- Fax
- 3148451864
- Primary Specialty
-
Orthodontics
1223X0400X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.