Individual
DR. JUDITH ROSENBLOOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
401 HOLLY HILLS AVE, SAINT LOUIS, MO 63111-2410
(314) 481-1615
Mailing address
401 HOLLY HILLS AVE, SAINT LOUIS, MO 63111-2410
(314) 481-1615
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
14974
MD
1223G0001X
General Practice Dentistry
Primary
2015040200
MO
1223G0001X
General Practice Dentistry
DL11248
MA
Other
Enumeration date
06/28/2011
Last updated
07/06/2016
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