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Individual

DR. JEFFREY T BLOOM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
631 ST ANNE ST, SUITE 105, RAPID CITY, SD 57701
(605) 343-6003
(605) 342-0998
Mailing address
631 ST ANNE ST, SUITE 105, RAPID CITY, SD 57701
(605) 343-6003
(605) 342-0998

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
M660
SD

Other

Enumeration date
11/14/2006
Last updated
03/31/2015
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