| NPI | 1588303275 |
|---|---|
| Doing Business As | BLOOMING DENTAL |
| Entity Type | Organization |
| Authorized Contact | GREGORY KOSTELAC Data Analyst 719-372-5605 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2022-06-01 |
| Last Update Date | 2022-06-01 |