Ira Terry Bloom DDS

NPI 1104970037 - Dentist - 1223G0001X

NPI Details
NPI 1104970037
Gender Male
Enumeration Date 01/22/2007
Last Updated 07/08/2007
Entity Type Individual
Active Over 9 years ago
Practice Location
2730 HANOVER PIKE
MANCHESTER MD, 21102-1914, US
Phone (410) 374-4882
Fax (410) 374-0702
Business Location
12 HOUNDSWOOD CT
BALTIMORE MD, 21209-1067, US
Phone (410) 484-8675
Fax
Toxanomy
Taxonomy Code 1223G0001X
License State Maryland
License Number 5176
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According to our database, Dr. Ira Terry Bloom DDS NPI is 1104970037, taxonomy code is 1223G0001X and license number is 5176, license state is located at Maryland. Ira Terry Bloom DDS physically located at 2730 Hanover Pike, Manchester MD, 21102-1914. NPI Number Ira Terry Bloom DDS has the Individual type.

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1104970037 NPI number is provided on an as is basis without warranty of any kind. 1104970037 is maintained by the National Plan & Provider Enumeration System. The contents of Ira Terry Bloom DDS are for informational purposes only.