Blue Diamond Family Dental Sc

NPI #1245433580 in Bloomer, Wisconsin

Provider Information

NPI Number: 1245433580
Entity Type: Organization
Organization Name: Blue Diamond Family Dental Sc
Primary Specialty: Dentist
Enumeration Date: Jun 6, 2007
Last Updated: Aug 22, 2020

Practice Location

Address: 1502 MAIN ST
City: Bloomer
State: Wisconsin
ZIP Code: 54724-1686
Phone: (715) 568-2363

Authorized Official

Name: MRS. CONNIE C PARR
Title: BUSINESS MANAGER
Phone: (715) 568-2363

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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