| Daniel R. Blazo, DDS, PLLC | |
|
22100 Outer Dr Dearborn MI 48124-3932 | |
| (313) 563-5855 | |
| Not Available |
| Full Name | Daniel R. Blazo, DDS, PLLC |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 22100 Outer Dr, Dearborn, Michigan |
| Authorized Official Name and Position | Daniel Blazo (OWNER) |
| Authorized Official Contact | 3135050985 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Daniel R. Blazo, DDS, PLLC 22100 Outer Dr Dearborn MI 48124-3932 Ph: (313) 563-5855 | Daniel R. Blazo, DDS, PLLC 22100 Outer Dr Dearborn MI 48124-3932 Ph: (313) 563-5855 |
| NPI Number | 1740859867 |
|---|---|
| Provider Enumeration Date | 06/22/2021 |
| Last Update Date | 06/22/2021 |
| Certification Date | 06/22/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740859867 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (NU) | Primary |
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