# MICHIGAN OMS P C

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

## Provider details

- **NPI number:** 1801906458
- **Authorized official:** DR. NICHOLAS J BOURNIAS DDS (PRESIDENT)
- **Authorized official phone:** (586) 228-9070

## Contact information

- **Practice address:** 6022 W MAPLE RD STE 405, WEST BLOOMFIELD, MI 48322-4408
- **Practice address phone:** (248) 855-2006
- **Practice address fax:** (248) 855-0571
- **Mailing address:** 6022 W MAPLE RD STE 405, WEST BLOOMFIELD, MI 48322-4408
- **Mailing address phone:** (248) 855-2006
- **Mailing address fax:** (248) 855-0571

## Taxonomy

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

## Other

- **Enumeration date:** 08/30/2006
- **Last updated:** 01/17/2024