Individual
AMY BLAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
2976 SUMMIT ST STE 201, OAKLAND, CA 94609-3405
(510) 451-8315
(510) 663-5833
Mailing address
2976 SUMMIT ST STE 201, OAKLAND, CA 94609-3405
(510) 451-8315
(510) 663-5833
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
64912
CA
Other
Enumeration date
05/19/2015
Last updated
09/27/2016
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