Organization
BLOOMFIELD DENTAL GROUP PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JESSICA JAMEEL KAKOS (PRESIDENT)
(248) 855-4143
Entity
Organization
Contact information
Practice address
6443 INKSTER RD STE 176, BLOOMFIELD HILLS, MI 48301-1303
(248) 855-4143
Mailing address
6443 INKSTER RD STE 176, BLOOMFIELD HILLS, MI 48301-1303
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2901018996
MI
Other
Enumeration date
12/02/2013
Last updated
12/02/2013
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