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Organization

BLOOM PEDIATRIC DENTISTRY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. BENJAMIN JAMES DDS (OWNER / DENTIST)
(541) 666-6091
Entity
Organization

Contact information

Practice address
410 E ELLENDALE AVE STE 1, DALLAS, OR 97338-3052
(503) 507-0996
Mailing address
410 E ELLENDALE AVE STE 1, DALLAS, OR 97338-3052
(503) 507-0996

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary

Other

Enumeration date
09/14/2020
Last updated
04/17/2026
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