Bloomfield Dental Care, Pllc | |
112 Fairfield Hl Bloomfield KY 40008-6127 | |
(502) 252-0056 | |
(502) 252-0058 |
Full Name | Bloomfield Dental Care, Pllc |
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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 |
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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 |
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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 |