Michael A. Bloom D.m.d. Pllc
Specialty details in registry · Hayden Lake, ID
At a glance
9928 N Government Way, Hayden Lake, ID 83835-9604
NPPES record updated May 7, 2013. Public records can lag behind changes at a practice.
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Practice location
9928 N Government WayHayden Lake, ID 83835-9604
Professional details: NPI, taxonomy & registry record
Registry details
- Primary taxonomy
- Specialty details in registry
- Taxonomy code
- 302R00000X
- Enumeration date
- May 7, 2013
- Record updated
- May 7, 2013
More registry details
- Provider type
- Organization · Type 2
Reported taxonomies and licenses
Specialty details in registry
302R00000X · Primary
License reported: D3394 ID
Specialty details in registry
302R00000X
License reported: D3555 ID
License numbers and credentials are reported to NPPES; HCPList does not independently verify them.
Practice location
9928 N Government WayHayden Lake, ID 83835-9604
- Phone
- (208) 772-3583
- Fax
- (208) 772-3224
Mailing address
PO BOX 425HAYDEN LAKE, ID 838350425
Information may be outdated or incomplete. Confirm details directly with the practice. HCPList is an independent directory and is not affiliated with CMS.
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