| Bloomfield Dental Care, Pllc | |
|
112 Fairfield Hl Bloomfield KY 40008-6127 | |
| (502) 252-0056 | |
| (502) 252-0058 |
| Full Name | Bloomfield Dental Care, Pllc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 112 Fairfield Hl, Bloomfield, Kentucky |
| Authorized Official Name and Position | Joshua Dolphus Blackmon (MEMBER / PARTNER) |
| Authorized Official Contact | 5023486404 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bloomfield Dental Care, Pllc 208 E Flaget Ave Bardstown KY 40004-1520 Ph: (502) 252-0056 | Bloomfield Dental Care, Pllc 112 Fairfield Hl Bloomfield KY 40008-6127 Ph: (502) 252-0056 |
| NPI Number | 1437297348 |
|---|---|
| Provider Enumeration Date | 02/02/2007 |
| Last Update Date | 05/13/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437297348 | NPI | - | NPPES |
| 6238 | Other | KY | PASSPORT |
| 267366 | Other | KY | UNITED CONCORDIA PROVIDER |
| 61943601 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 6805 (Kentucky) | Primary |