Individual
DR. BLAZE KROGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
7101 HOFF ST, FORT BENNING, GA 31905-5645
(706) 544-2573
Mailing address
7101 HOFF ST, FORT BENNING, GA 31905-5645
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN122284
GA
Other
Enumeration date
06/16/2021
Last updated
06/16/2021
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