Organization
MITCHELL J. BLOOM, D.M.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MITCHELL J. BLOOM D.M.D. (PRESIDENT)
(212) 327-3623
Entity
Organization
Contact information
Practice address
880 5TH AVE, SUITE 1-G, NEW YORK, NY 10021-4951
(212) 327-2623
Mailing address
880 5TH AVE, SUITE 1-G, NEW YORK, NY 10021-4951
(212) 327-2623
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
045016
NY
Other
Enumeration date
11/13/2006
Last updated
07/30/2014
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