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Organization
BLOOMFIELD DENTAL CARE, PLLC
Active
Organization
BLOOMFIELD DENTAL CARE, PLLC
Active
Other names
Bloomfield Dental Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSHUA DOLPHUS BLACKMON DMD (MEMBER / PARTNER)
(502) 348-6404
Entity
Organization
Contact information
Practice address
112 FAIRFIELD HL, BLOOMFIELD, KY 40008-6127
(502) 252-0056
(502) 252-0058
Mailing address
208 E FLAGET AVE, BARDSTOWN, KY 40004-1520
(502) 252-0056
(502) 252-0058
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6805
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
267366
UNITED CONCORDIA PROVIDER
KY
05
—
61943601
—
KY
01
—
6238
PASSPORT
KY
Enumeration date
02/02/2007
Last updated
05/13/2025
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