| 100 South Bloomfield Professional, Llc | |
|
100 S 1st St Bloomfield NM 87413-6242 | |
| (505) 632-3344 | |
| Not Available |
| Full Name | 100 South Bloomfield Professional, Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 100 S 1st St, Bloomfield, New Mexico |
| Authorized Official Name and Position | Peter Grumbos (OWNER) |
| Authorized Official Contact | 5056323344 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| 100 South Bloomfield Professional, Llc 100 S 1st St Bloomfield NM 87413-6242 Ph: (505) 632-3344 | 100 South Bloomfield Professional, Llc 100 S 1st St Bloomfield NM 87413-6242 Ph: (505) 632-3344 |
| NPI Number | 1912519067 |
|---|---|
| Provider Enumeration Date | 08/20/2020 |
| Last Update Date | 08/20/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912519067 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
Sundance Dental Care Of Bloomfield, Llc. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 100 South First Street, Bloomfield, NM 87413 Phone: 505-632-3344 | |
Dzilth-na-o-dith-hle Health Center Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 6 Road 7586, Bloomfield, NM 87413 Phone: 505-368-6401 Fax: 505-368-6431 |