Individual
DR. BLAKE MICHAEL SHAFFOU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
13403 E 13 MILE RD, WARREN, MI 48088-3188
(586) 979-2800
Mailing address
1091 FOREST BAY CT, WATERFORD, MI 48328-4283
(248) 672-9202
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901602609
MI
Other
Enumeration date
07/10/2025
Last updated
07/10/2025
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