Michael A. Bloom D.m.d. Pllc
NPI #1033554845 in Hayden Lake, Idaho
Provider Information
- NPI Number
- 1033554845
- Entity Type
- Organization
- Organization Name
- Michael A. Bloom D.m.d. Pllc
- Primary Specialty
- Health Maintenance Organization
- Enumeration Date
- May 7, 2013
- Last Updated
- May 7, 2013
Practice Location
- Address
- 9928 N GOVERNMENT WAY
- City
- Hayden Lake
- State
- Idaho
- ZIP Code
- 83835-9604
- Phone
- (208) 772-3583
Authorized Official
- Name
- MRS. KATHY L. MARKS
- Title
- OFFICE MANAGER
- Phone
- (208) 772-3583
Specialties & Taxonomy Codes
| Specialty |
|---|
| Health Maintenance Organization |
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