Individual
DR. KERRY MARK BLOOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
6560 FANNIN ST STE 1434, HOUSTON, TX 77030-2713
(713) 795-0130
(713) 795-0470
Mailing address
6560 FANNIN ST STE 1434, HOUSTON, TX 77030-2713
(713) 795-0130
(713) 795-0470
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
10986
TX
Other
Enumeration date
08/04/2006
Last updated
07/08/2007
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