National Provider Identifier Database

BLOOM ENDO LLC
Endodontics

The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions.


Contact Information

BLOOM ENDO, LLC
617 MYERS RD STE B
SUMMERVILLE, SC29486-8902
Phone: 843-647-6052
Fax:
Website:
Specialty Taxonomy Code
* Endodontics 1223E0200X

* Indicates primary specialty

NPI Profile & details for BLOOM ENDO, LLC

NPI Number 1679342042
Legal business name
LBN
BLOOM ENDO, LLC
Authorized official TIMOTHY GIBSON - (ENDODONTIST/OWNER)
Entity Organization
Organization subpart No
Enumeration date 12/27/2023
Last updated 02/13/2024 - About 2 years ago
Sole proprietor1 Not specified
Identifiers n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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