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Organization

BLOOM ENDO, LLC

Active
Other names
Bloom Endodontics
Organization subpart
No

Provider details

NPI number
Authorized official
DR. TIMOTHY CURTIS GIBSON JR. DDS, MS (ENDODONTIST/OWNER)
(843) 647-6052
Entity
Organization

Contact information

Practice address
617 MYERS RD STE B, SUMMERVILLE, SC 29486-8902
(843) 647-6052
Mailing address
617 MYERS RD STE B, SUMMERVILLE, SC 29486-8902
(843) 647-6052

Taxonomy

Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary

Other

Enumeration date
12/27/2023
Last updated
02/13/2024
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