Organization
ZOMA DENTAL PRACTICE PLLC
Active
Other names
Zoma Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACQUELINE ZOMA DDS (DENTIST)
(248) 807-1420
Entity
Organization
Contact information
Practice address
6330 ORCHARD LAKE RD STE 130, WEST BLOOMFIELD, MI 48322-2398
(248) 932-0550
Mailing address
6330 ORCHARD LAKE RD STE 130, WEST BLOOMFIELD, MI 48322-2398
(248) 932-0550
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1223G001X
DENTAL INSURANCE CARRIERS
MI
Enumeration date
09/10/2020
Last updated
03/28/2023
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