| Bloom Pediatric Dentistry | |
|
201 Se Washington St Ste A Dallas OR 97338-2860 | |
| (503) 507-0996 | |
| Not Available |
| Full Name | Bloom Pediatric Dentistry |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 201 Se Washington St Ste A, Dallas, Oregon |
| Authorized Official Name and Position | Benjamin James (OWNER / DENTIST) |
| Authorized Official Contact | 5416666091 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bloom Pediatric Dentistry 201 Se Washington St Ste A Dallas OR 97338-2860 Ph: (503) 507-0996 | Bloom Pediatric Dentistry 201 Se Washington St Ste A Dallas OR 97338-2860 Ph: (503) 507-0996 |
| NPI Number | 1841805991 |
|---|---|
| Provider Enumeration Date | 09/14/2020 |
| Last Update Date | 11/09/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841805991 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
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