Organization
BLOOM DENTAL, LLC
Active
Other names
Crystal Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
ALYAA K MAFRAG DMD (OWNER)
(210) 803-8889
Entity
Organization
Contact information
Practice address
3970 FM 2181 STE 200, HICKORY CREEK, TX 75065-4249
(940) 600-5365
Mailing address
3970 FM 2181 STE 200, HICKORY CREEK, TX 75065-4249
(940) 600-5365
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
09/01/2023
Last updated
04/04/2024
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