Provider Demographics
NPI:1275500183
Name:BLOOD, WILLIAM STEPHEN (DDS MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:STEPHEN
Last Name:BLOOD
Suffix:
Gender:M
Credentials:DDS MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:26777 LORAIN RD
Mailing Address - Street 2:#600
Mailing Address - City:NORTH OLMSTED
Mailing Address - State:OH
Mailing Address - Zip Code:44070-3222
Mailing Address - Country:US
Mailing Address - Phone:440-734-3131
Mailing Address - Fax:440-734-3466
Practice Address - Street 1:26777 LORAIN RD
Practice Address - Street 2:#600
Practice Address - City:NORTH OLMSTED
Practice Address - State:OH
Practice Address - Zip Code:44070-3222
Practice Address - Country:US
Practice Address - Phone:440-734-3131
Practice Address - Fax:440-734-3466
Is Sole Proprietor?:No
Enumeration Date:2006-03-01
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH350681291223S0112X
OH30.0186981223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH350681298OtherMEDICAL
OH30188698OtherDENTAL
OH30188698OtherDENTAL
BB2777716OtherDEA
OH30188698OtherDENTAL