Individual
OLOF LOWRY BLOMBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
3515 CENTRAL PIKE, SUITE 202, HERMITAGE, TN 37076-2029
(615) 889-4658
(615) 889-2989
Mailing address
114 SEVEN SPRINGS DR, MT JULIET, TN 37122-3859
(615) 301-1614
(615) 889-2989
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
8452
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q027151
—
TN
Enumeration date
10/10/2006
Last updated
04/26/2017
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