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Organization

BLAKE K ANDERSON DMD LLC

Active
Other names
A Street Dental
Organization subpart
No

Provider details

NPI number
Authorized official
DR. BLAKE K ANDERSON DMD (DOCTOR/OWNER)
(916) 765-7036
Entity
Organization

Contact information

Practice address
828 NE A ST, GRANTS PASS, OR 97526-2212
(541) 476-9792
Mailing address
4674 E FOXWOOD DR, EAGLE MOUNTAIN, UT 84005-6176

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary

Other

Enumeration date
05/14/2021
Last updated
05/14/2021
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