Individual
KENNETH BLOODWORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2001 WINDY TER, STE F, CEDAR PARK, TX 78613-4289
(210) 393-1704
Mailing address
1674 LANTANA CIR, NEW BRAUNFELS, TX 78130-1109
(210) 393-1704
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
11369
TX
Other
Enumeration date
03/07/2013
Last updated
03/07/2013
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