Provider Demographics
NPI:1891923843
Name:MAIDA, BLAKE DYSON (DDS, MD)
Entity Type:Individual
Prefix:DR
First Name:BLAKE
Middle Name:DYSON
Last Name:MAIDA
Suffix:
Gender:M
Credentials:DDS, MD
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Mailing Address - Street 1:7500 SAN FELIPE ST STE 300
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77063-1716
Mailing Address - Country:US
Mailing Address - Phone:713-457-6337
Mailing Address - Fax:713-457-6341
Practice Address - Street 1:7500 SAN FELIPE ST STE 300
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77063-1716
Practice Address - Country:US
Practice Address - Phone:713-457-6337
Practice Address - Fax:713-457-6341
Is Sole Proprietor?:No
Enumeration Date:2009-06-29
Last Update Date:2022-07-21
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Provider Licenses
StateLicense IDTaxonomies
TX24660204E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery