LARRY DEAN BLOOM

HUDSON, WI
NPI1467716167
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1223P0221X Dentist, Pediatric Dentistry
(Licence: WI  6844-15)
Enumeration Date2012-06-27
Last Update Date2012-06-28
Business Address
-- LARRY DEAN BLOOM DDS
131 CARMICHAEL RD STE 200
HUDSON, WI 54016-8271
Phone number: 855-527-3848
Mailing Address
-- LARRY DEAN BLOOM DDS
131 CARMICHAEL RD STE 200
HUDSON, WI 54016-8271
Phone number: 855-527-3848