Individual
DR. JOHN BLOOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1680 HUGUENOT RD, MIDLOTHIAN, VA 23113-2427
(804) 379-7120
(804) 379-9835
Mailing address
1680 HUGUENOT RD, MIDLOTHIAN, VA 23113-2427
(804) 379-7120
(804) 379-9835
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
0401415472
VA
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
0438000369
VA
Other
Enumeration date
07/24/2008
Last updated
09/17/2021
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