DR. John Douglas Bloom, DDS
NPI #1255319364 in Great Lakes, Illinois
Provider Information
- NPI Number
- 1255319364
- Entity Type
- Individual
- Name
- DR. John Douglas Bloom, DDS
- Gender
- Not Specified
- Sole Proprietor
- Not Answered
- Primary Specialty
- Dentist
- Credential
- DDS
- Enumeration Date
- Jan 9, 2006
- Last Updated
- Jul 8, 2007
Practice Location
- Address
- 3001 6TH ST
- City
- Great Lakes
- State
- Illinois
- ZIP Code
- 60088-2833
- Phone
- (847) 688-2100
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist |
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