Organization
BLOOMING DENTAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES J LEE (OWNER)
(512) 250-2356
Entity
Organization
Contact information
Practice address
111 N VISTA RIDGE BLVD, STE 100, CEDAR PARK, TX 78613-0000
(512) 250-2356
Mailing address
111 N VISTA RIDGE BLVD, STE 100, CEDAR PARK, TX 78613-0000
(512) 250-2356
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
19039
TX
Other
Enumeration date
05/10/2016
Last updated
05/10/2016
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