Individual
DR. ROBERT JAY BLOOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
393 N DUNLAP ST, SUITE 100 CENTRAL MEDICAL BLDG, ST PAUL, MN 55104
(651) 646-1318
(651) 642-2592
Mailing address
393 N DUNLAP ST, SUITE 100 CENTRAL MEDICAL BLDG, ST PAUL, MN 55104
(651) 646-1318
(651) 642-2592
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
8022
MN
Other
Enumeration date
11/21/2006
Last updated
07/08/2007
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