Individual
DR. JAMES MATTHEW BLOOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
11949 LIONESS WAY STE 100, PARKER, CO 80134-6083
(443) 804-1967
Mailing address
11949 LIONESS WAY STE 100, PARKER, CO 80134-6083
(443) 804-1967
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
80136689921
UT
1223G0001X
General Practice Dentistry
HAD34
FL
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DEN.00203556
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004058400
—
FL
Enumeration date
06/21/2011
Last updated
08/16/2021
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