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Dr. Matthew Bloomberg, D.M.D. , M.S.

Dentist, Orthodontics and Dentofacial Orthopedics in Okemos, MI. Individual provider (NPI-1).

NPI number1093171233
StatusActive
Last updated in NPPESMar 24, 2020

Details

NPI
1093171233
Entity type
Individual (NPI-1)
Name
Dr. Matthew Bloomberg
Credential
D.M.D. , M.S.
Sex
Male
Sole proprietor
No
Enumeration date
Jan 4, 2016
Certification date
Mar 24, 2020
Last updated
Mar 24, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics2901021647MIYes
122300000X Dentist2901021647MI

Practice location

4111 Okemos Rd Ste 201
Okemos, MI 48864-3235

Phone 517-347-0946

Mailing address

4111 Okemos Rd Ste 201
Okemos, MI 48864-3235

Other practice locations

1040 Charlevoix Dr Ste C
Grand Ledge, MI 48837-2417

Phone 517-347-0946

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