| NPI | 1972325306 |
|---|---|
| Doing Business As | BLOOMY'S PEDIATRIC DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | ACKEILIA K HEATRICE Owner 636-333-9711 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Enumeration Date | 2024-10-28 |
| Last Update Date | 2024-10-28 |