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NPI Profile for LARRY D BLOOM in HUDSON, WI.
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Pediatric Dentistry |
1223P0221X |
| NPI Number | 1467716167 |
|
| Status | Active | |
| Credentials | DDS (Doctor of Dental Surgery) | |
| Entity | Individual | |
| Enumeration date | 06/27/2012 | |
| Last updated | 06/28/2012 - About 14 years ago | |
| Sole proprietor 1 | No | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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LARRY D BLOOM
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