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Larry Dean Bloom, DDS
Pediatric Dentist in Hudson, Wisconsin
NPI 1467716167

Larry Dean Bloom is a Pediatric Dentist based in Hudson, WI and is specialized in Pediatric Dentistry. Larry Dean Bloom practices in Hudson, WI and has the professional credentials of DDS. The NPI Number for Larry Dean Bloom is 1467716167 and holds a License No. 6844-15 (Wisconsin).

The current practice location address for Larry Dean Bloom is 131 Carmichael Rd Ste 200, Hudson, WI and can be reached out via phone at 855-527-3848.

Location: 131 Carmichael Rd Ste 200, Hudson, WI, 54016-8271
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1467716167
Provider Name
Larry Dean Bloom
Credential
DDS
Provider Entity Type
Individual
Gender
Male
Address
131 Carmichael Rd Ste 200, Hudson, WI, 54016-8271
Phone Number
855-527-3848
Fax Number
Provider Enumeration Date
06/27/2012
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
131 Carmichael Rd Ste 200
City
Hudson
State
Wisconsin
Zip
54016-8271
Phone Number
855-527-3848
Fax Number
person
Provider Business Mailing Address Details
Address
131 Carmichael Rd Ste 200
City
Hudson
State
Wisconsin
Zip
54016-8271
Phone Number
855-527-3848
Fax Number
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Pediatric Dentistry
Taxonomy
1223P0221X
License No.
6844-15 (Wisconsin)
Definition
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
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