# BRIAN J. BLOCHER DDS SC

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

## Provider details

- **NPI number:** 1699088369
- **Authorized official:** DR. BRIAN JOSEPH BLOCHER DDS SC (OWNER/ORAL SURGEON)
- **Authorized official phone:** (414) 607-0222

## Contact information

- **Practice address:** 201 N MAYFAIR RD STE 520, WAUWATOSA, WI 53226-4216
- **Practice address phone:** (414) 607-0222
- **Practice address fax:** (414) 607-0220
- **Mailing address:** 201 N MAYFAIR RD STE 520, WAUWATOSA, WI 53226-4216
- **Mailing address phone:** (414) 607-0222
- **Mailing address fax:** (414) 607-0220

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 4002 | WI | Yes |

## Other

- **Enumeration date:** 07/22/2010
- **Last updated:** 05/13/2015