Organization
WEST BLOOMFIELD AESTHETIC SURGERY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FANNY DELA CRUZ MD (OWNER)
(248) 539-1009
Entity
Organization
Contact information
Practice address
31224 MULFORDTON ST, SUITE 210, FARMINGTON HILLS, MI 48334-1407
(247) 538-1998
(248) 522-6506
Mailing address
31224 MULFORDTON ST, SUITE 210, FARMINGTON HILLS, MI 48334-1407
(247) 538-1998
(248) 522-6506
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
4301036977
MI
Other
Enumeration date
11/06/2009
Last updated
11/06/2009
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