Bloom, Larry Dean
Bloom, Larry Dean is an individual health care provider with primary practice located at 131 Carmichael Rd Ste 200 , Hudson WI 54016-8271. He recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as his primary health care specialty. Bloom, Larry Dean can be contacted via phone (855) 527-3848.Contact Information
Primary practice address
131 Carmichael Rd Ste 200
Hudson WI 54016-8271
Phone: (855) 527-3848
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Pediatric Dentistry | 1223P0221X | 6844-15 | Wisconsin |
Profile Details
| NPI number | 1467716167 |
|---|---|
| LBN Legal business name | Bloom, Larry Dean |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 27th, 2012 |
| Last updated | Jun 28th, 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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