Aaron Forsythe Bloom, DDS

Individual provider Active NPI Pediatric Dentistry · Murrells Inlet, SC

NPI 1265697387 · NPPES record last updated Mar 17, 2018

Key facts

NPI
1265697387
Entity type
Individual (NPI type 1)
Primary specialty
Pediatric Dentistry 1223P0221X
License
937 (SC)
Practice address
4410 Highway 17 Unit B6
Murrells Inlet, SC 29576-6434
Phone
(304) 419-0188
NPI assigned
Jul 29, 2008
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
8879SCMDClinical Social Worker
3833WVMDGeneral Practice Dentistry
937SCMDOptometrist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 3833 WV
Pediatric Dentistry
Group: 193400000X SINGLE SPECIALTY GROUP
1223P0221X 937 SC Yes
General Practice Dentistry 1223G0001X 8879 SC

Addresses

Primary practice location

4410 Highway 17 Unit B6
Murrells Inlet, SC 29576-6434

Mailing address

4410 Highway 17 Unit B6
Murrells Inlet, SC 29576-6434

Other practice location 1

1021 Quarrier St
Suite 517 Medical Arts Bldg
Charleston, WV 25301-2338
Phone (304) 345-7272

Other providers in Murrells Inlet, SC

All providers in Murrells Inlet, SC · Pediatric Dentistry in South Carolina

Sources for this page

Verify at the official NPI Registry.