Jonathan A Bloom D.D.S.

NPI 1093884462 - Dentist - 1223G0001X

NPI Details
NPI 1093884462
Gender Male
Enumeration Date 11/07/2006
Last Updated 05/16/2012
Entity Type Individual
Active Over 10 years ago
Practice Location
118 TILLEY DR STE 101
SOUTH BURLINGTON VT, 05403-4450, US
Phone (802) 863-3950
Fax (802) 863-3601
Business Location
120 NICKLAUS CIR
SOUTH BURLINGTON VT, 05403-8015, US
Phone (802) 497-0814
Fax (802) 497-0814
Toxanomy
Taxonomy Code 1223G0001X
License State Vermont
License Number 2268
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According to our database, Dr. Jonathan A Bloom D.D.S. NPI is 1093884462, taxonomy code is 1223G0001X and license number is 2268, license state is located at Vermont. Jonathan A Bloom D.D.S. physically located at 118 Tilley Dr Ste 101, South Burlington VT, 05403-4450. NPI Number Jonathan A Bloom D.D.S. has the Individual type.

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1093884462 NPI number is provided on an as is basis without warranty of any kind. 1093884462 is maintained by the National Plan & Provider Enumeration System. The contents of Jonathan A Bloom D.D.S. are for informational purposes only.