Dr. Blake E. Marston, DDS
Dentist, Orthodontics and Dentofacial Orthopedics in San Diego, CA. Individual provider (NPI-1).
NPI number1467463521
StatusActive
Last updated in NPPESJun 1, 2011
Details
- NPI
- 1467463521
- Entity type
- Individual (NPI-1)
- Name
- Dr. Blake E. Marston
- Credential
- DDS
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Aug 11, 2006
- Last updated
- Jun 1, 2011
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223X0400X | Dentist, Orthodontics and Dentofacial Orthopedics | 55966 | CA | Yes |
| 1223X0400X | Dentist, Orthodontics and Dentofacial Orthopedics | D6621 | AZ |
Practice location
9330 Carmel Mountain RdSuite D
San Diego, CA 92129-2157
Phone 858-484-6100 · Fax 858-484-8601
Mailing address
9330 Carmel Mountain RdSuite D
San Diego, CA 92129-2157
Phone 858-484-6100 · Fax 858-484-8601
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