Individual
WILLIAM F JEROME
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S, M.S.
Contact information
Practice address
9448 STONEBROOK, CHARLEVOIX, MI 49720-2081
(231) 547-5470
Mailing address
9448 STONEBROOK, CHARLEVOIX, MI 49720-2081
(231) 547-5470
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
2901008585
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2901008585
DENTISTRY LICENSE
MI
01
—
J085850
BCBSM PIN
MI
Enumeration date
04/16/2008
Last updated
03/07/2023
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