| Bloomfield Oral Health | |
|
54 W Main St Bloomfield NY 14469 | |
| (585) 657-6909 | |
| (585) 657-7016 |
| Full Name | Bloomfield Oral Health |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 54 W Main St, Bloomfield, New York |
| Authorized Official Name and Position | Sunook Hwang (DOCTOR/OWNER) |
| Authorized Official Contact | 5856576909 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bloomfield Oral Health 54 W Main St Po Box 369 Bloomfield NY 14469 Ph: (585) 657-6909 | Bloomfield Oral Health 54 W Main St Bloomfield NY 14469 Ph: (585) 657-6909 |
| NPI Number | 1477863678 |
|---|---|
| Provider Enumeration Date | 10/21/2010 |
| Last Update Date | 10/21/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477863678 | NPI | - | NPPES |
| 02676020 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 051500-1 (New York) | Primary |
Randall K. Freeman, Dds Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 54 West Main Street, Bloomfield, NY 14469 Phone: 585-657-6909 Fax: 585-657-7016 |