| NPI | 1992913784 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS J BLOEM President 734-995-4699 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: MI 2901011268) |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2020-08-22 |