Mark Arnold Bloomquist, DDS
Individual provider Active NPI General Practice Dentistry · Spicer, MN
NPI 1962557587 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1962557587
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 9390 (MN)
- Practice address
- 315 Access Dr
Spicer, MN 56288 - Phone
- (320) 796-2158
- Fax
- (320) 796-2158
- NPI assigned
- Jan 24, 2007
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9390 | MN | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 9390 | MN | Yes |
Addresses
Primary practice location
315 Access Dr
Spicer, MN 56288
Mailing address
PO Box 10
315 Access Dr
Spicer, MN 56288
Phone (320) 796-2158
Other providers in Spicer, MN
- Ametrine Mental Health PLLC
- Dillon Caskey
- Cedar Crest, Inc
- Baylie Clark
- Benjamin Henry Dobmeier
- Debra Donahue-Sharstrom
All providers in Spicer, MN · General Practice Dentistry in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.