| NPI | 1821488917 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID A BLOOM Owner 603-893-6120 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics |
| Enumeration Date | 2015-01-28 |
| Last Update Date | 2015-01-28 |