Individual
DR. BLAIR GREGORY OTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS, MD
Contact information
Practice address
4980 BARRANCA PKWY STE 190, IRVINE, CA 92604-8652
(949) 453-9797
(949) 872-2468
Mailing address
4980 BARRANCA PKWY STE 190, IRVINE, CA 92604-8652
(949) 453-9797
Taxonomy
Speciality
Code
Description
License number
State
1223P0106X
Oral and Maxillofacial Pathology Dentistry
Primary
24159
CA
Other
Enumeration date
11/17/2006
Last updated
07/09/2007
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