Individual
DR. CHARLES HENRY BLOOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
815 LIVINGSTON AVE, NEW BRUNSWICK, NJ 08901-3344
(732) 249-6386
(732) 249-6283
Mailing address
815 LIVINGSTON AVE, NEW BRUNSWICK, NJ 08901-3344
(732) 249-6386
(732) 249-6283
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
22DI01554800
NJ
Other
Enumeration date
05/18/2007
Last updated
07/08/2007
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