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Organization

BLOOMING FAMILY DENTAL LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. THEODORE K CHANG DDS (OWNER)
(646) 673-4496
Entity
Organization

Contact information

Practice address
749 BLOOMFIELD AVE STE D, WEST CALDWELL, NJ 07006-6717
(646) 673-4496
Mailing address
749 BLOOMFIELD AVE STE D, WEST CALDWELL, NJ 07006-6717
(973) 787-8437

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
22DI02565000
NJ
332BC3200X
Customized Equipment (DME)

Other

Enumeration date
07/05/2018
Last updated
09/05/2025
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