IndividualActive
Blake Borello, D.D.S., M.S.
NPI 1902114515 · Orthodontics and Dentofacial Orthopedics Dentistry · Lake Saint Louis, MO
Provider details
- NPI number
- 1902114515
- Entity type
- Individual
- Primary specialty
- Orthodontics and Dentofacial Orthopedics DentistryDental Providers
- Credential
- D.D.S., M.S.
- Sex
- Male
- Sole proprietor
- No
- License
- 2008019644 (MO)
Specialties & taxonomies
Dental Providers
Practice location
6288 Ronald Reagan Dr.
Lake Saint Louis, MO 63367
Phone: (636) 625-4224
Fax: (314) 845-1864
Approximate (ZIP-level) locationGet directions
Mailing address
1203 Saint Charles St
Saint Louis, MO 63103-1963
Registry dates
- Enumerated
- 2010-09-16
- Last updated
- 2011-02-02
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.