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1457766081
BLAKE UPSHAW
CUMMING, GA
NPI
1457766081
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
122300000X Dentist
(Licence: GA DN014775)
Enumeration Date
2014-06-23
Last Update Date
2014-06-23
Business Address
Dr. BLAKE UPSHAW DMD
1200 BALD RIDGE MARINA RD SUITE 200
CUMMING, GA 30041-8526
Phone number: 770-781-8650
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Mailing Address
Dr. BLAKE UPSHAW DMD
PO BOX 599
CUMMING, GA 30028-0599
Phone number: 770-781-8650
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