Provider Demographics
NPI:1841505088
Name:GREGG D. BOBIER, DMD, PC
Entity type:Organization
Organization Name:GREGG D. BOBIER, DMD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGG
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:BOBIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-656-8880
Mailing Address - Street 1:1000 W UNIVERSITY DR
Mailing Address - Street 2:SUITE 201
Mailing Address - City:ROCHESTER
Mailing Address - State:MI
Mailing Address - Zip Code:48307-1873
Mailing Address - Country:US
Mailing Address - Phone:248-656-8880
Mailing Address - Fax:248-656-9081
Practice Address - Street 1:1000 W UNIVERSITY DR
Practice Address - Street 2:SUITE 201
Practice Address - City:ROCHESTER
Practice Address - State:MI
Practice Address - Zip Code:48307-1873
Practice Address - Country:US
Practice Address - Phone:248-656-8880
Practice Address - Fax:248-656-9081
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-12
Last Update Date:2010-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901013708261QD0000X, 261QS0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS0112XAmbulatory Health Care FacilitiesClinic/CenterOral and Maxillofacial Surgery
No261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5637022OtherBCBSM
MI10-4473123Medicaid
MI12-4473099Medicaid
MI0N21250Medicare UPIN