Organization
NORTHVILLE ORAL &FACIAL SURGERY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PETER TIMOTHY BLISS DMD (PRESIDENT)
(248) 344-4224
Entity
Organization
Contact information
Practice address
430 N CENTER ST, NORTHVILLE, MI 48167-1224
(248) 344-4224
(248) 344-4883
Mailing address
430 N CENTER ST, NORTHVILLE, MI 48167-1224
(248) 344-4224
(248) 344-4883
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
D166720
MI
Other
Enumeration date
11/06/2009
Last updated
11/06/2009
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