Individual
BLAKE EATON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1120 15TH ST # GC5110, AUGUSTA, GA 30912-0004
(307) 349-9193
Mailing address
720 UNIVERSITY VLG, SALT LAKE CITY, UT 84108-3431
(307) 349-9193
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/09/2023
Last updated
03/09/2023
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