Bloom, Justin R

Bloom, Justin R is an individual health care provider with primary practice located at 137 Prospect Hill Rd Suite C, East Windsor CT 06088-3602. He recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as his primary health care specialty. Bloom, Justin R can be contacted via phone (860) 254-5840.

Contact Information

Primary practice address
137 Prospect Hill Rd Suite C East Windsor CT 06088-3602
Phone: (860) 254-5840
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Pediatric Dentistry 1223P0221X 010228 Connecticut
Dental Providers / Pediatric Dentistry 1223P0221X DS037518 Pennsylvania

Profile Details

NPI number 1235385410
LBN Legal business name Bloom, Justin R
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 7th, 2008
Last updated Jan 23rd, 2012 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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