| Brian J. Blocher Dds Sc | |
|
201 N Mayfair Rd Ste 520 Wauwatosa WI 53226-4216 | |
| (414) 607-0222 | |
| (414) 607-0220 |
| Full Name | Brian J. Blocher Dds Sc |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 201 N Mayfair Rd Ste 520, Wauwatosa, Wisconsin |
| Authorized Official Name and Position | Brian Joseph Blocher (OWNER/ORAL SURGEON) |
| Authorized Official Contact | 4146070222 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Brian J. Blocher Dds Sc 201 N Mayfair Rd Ste 520 Wauwatosa WI 53226-4216 Ph: (414) 607-0222 | Brian J. Blocher Dds Sc 201 N Mayfair Rd Ste 520 Wauwatosa WI 53226-4216 Ph: (414) 607-0222 |
| NPI Number | 1699088369 |
|---|---|
| Provider Enumeration Date | 07/22/2010 |
| Last Update Date | 05/13/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699088369 | NPI | - | NPPES |
| 33683900 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 4002 (Wisconsin) | Primary |
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