Provider Demographics
NPI:1255467627
Name:BLOCHER, WILLIAM B (DDS)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:B
Last Name:BLOCHER
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 1:1455 E GUADALUPE ROAD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85283
Mailing Address - Country:US
Mailing Address - Phone:480-831-6440
Mailing Address - Fax:480-831-6751
Practice Address - Street 1:1455 E GUADALUPE ROAD
Practice Address - Street 2:SUITE 1
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85283
Practice Address - Country:US
Practice Address - Phone:480-831-6440
Practice Address - Fax:480-831-6751
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2452122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist