# BLOOMFIELD DENTAL GROUP PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1306277363
- **Authorized official:** DR. JESSICA JAMEEL KAKOS (PRESIDENT)
- **Authorized official phone:** (248) 855-4143

## Contact information

- **Practice address:** 6443 INKSTER RD STE 176, BLOOMFIELD HILLS, MI 48301-1303
- **Practice address phone:** (248) 855-4143
- **Mailing address:** 6443 INKSTER RD STE 176, BLOOMFIELD HILLS, MI 48301-1303

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 2901018996 | MI | Yes |

## Other

- **Enumeration date:** 12/02/2013
- **Last updated:** 12/02/2013