Organization
BRIAN J. BLOCHER DDS SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIAN JOSEPH BLOCHER DDS SC (OWNER/ORAL SURGEON)
(414) 607-0222
Entity
Organization
Contact information
Practice address
201 N MAYFAIR RD STE 520, WAUWATOSA, WI 53226-4216
(414) 607-0222
(414) 607-0220
Mailing address
201 N MAYFAIR RD STE 520, WAUWATOSA, WI 53226-4216
(414) 607-0222
(414) 607-0220
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
4002
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33683900
—
WI
Enumeration date
07/22/2010
Last updated
05/13/2015
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