Provider Demographics
NPI:1174601553
Name:BLOINK, DAVID H (DDS)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:H
Last Name:BLOINK
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34020 SEVEN MILE RD
Mailing Address - Street 2:SUITE 121
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48152-3093
Mailing Address - Country:US
Mailing Address - Phone:248-471-3781
Mailing Address - Fax:248-473-0211
Practice Address - Street 1:34020 SEVEN MILE RD
Practice Address - Street 2:SUITE 121
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48152-3093
Practice Address - Country:US
Practice Address - Phone:248-471-3781
Practice Address - Fax:248-473-0211
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010139151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI58262819NOtherBCBS