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Organization
BLUE MOUNTAIN DENTAL LLC
Active
Organization
BLUE MOUNTAIN DENTAL LLC
Active
Other names
Blue Mountain Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JESSE BLOOMFIELD DMD (DOCTOR)
(435) 406-4006
Entity
Organization
Contact information
Practice address
60 S 300 EAST, DELTA, UT 84624
(435) 864-5195
(435) 864-5199
Mailing address
PO BOX 310, DELTA, UT 84624-0310
(435) 864-5195
(435) 864-5199
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
11/08/2023
Last updated
11/08/2023
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