Individual
WILLIAM S BLOOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
11300 EAST THIRTEEN MILE ROAD, WARREN, MI 48093
(586) 573-7777
(586) 573-7584
Mailing address
11300 13 MILE ROAD, WARREN, MI 48093
(586) 573-7777
(586) 573-7584
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
2901010395
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2642399
—
MI
Enumeration date
07/25/2006
Last updated
07/08/2007
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