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100 South Bloomfield Professional, LLC — NPI 1912519067, Bloomfield, NM | NPI Central

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NPI 1912519067

OrganizationActive

100 South Bloomfield Professional, LLC

NPI 1912519067 · General Practice Dentistry · Bloomfield, NM

Provider details

NPI number: 1912519067
Entity type: Organization
Primary specialty: General Practice DentistryDental Providers
Authorized official: Peter Grumbos, Owner

Practice location

100 S 1st St

Bloomfield, NM 87413-6242

Phone: (505) 632-3344

More NM providers

Mailing address

100 S 1st St

Bloomfield, NM 87413-6242

Registry dates

Enumerated: 2020-08-20
Last updated: 2020-08-20

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.