Organization
BLOOMFIELD DENTAL CARE, PLLC
Active
Other names
Bloomfield Dental Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSHUA DOLPHUS BLACKMON DMD (MEMBER / PARTNER)
(502) 348-6404
Entity
Organization
Contact information
Practice address
112 FAIRFIELD HL, BLOOMFIELD, KY 40008-6127
(502) 252-0056
(502) 252-0058
Mailing address
208 E FLAGET AVE, BARDSTOWN, KY 40004-1520
(502) 252-0056
(502) 252-0058
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6805
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
267366
UNITED CONCORDIA PROVIDER
KY
05
—
61943601
—
KY
01
—
6238
PASSPORT
KY
Enumeration date
02/02/2007
Last updated
05/13/2025
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