Individual
DR. BLAKE TAYLOR ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
655 N BELAIR RD, EVANS, GA 30809-4219
(706) 855-0052
Mailing address
1106 AZALEA DR, AUGUSTA, GA 30904-3323
(706) 373-4587
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN122726
GA
Other
Enumeration date
07/01/2022
Last updated
07/04/2022
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