Provider Demographics
NPI:1730962770
Name:KATLIN ALLEN BLOOMER DMD INC
Entity type:Organization
Organization Name:KATLIN ALLEN BLOOMER DMD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:KATLIN
Authorized Official - Middle Name:A
Authorized Official - Last Name:BLOMER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:513-979-6998
Mailing Address - Street 1:3136 MADISON RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45209
Mailing Address - Country:US
Mailing Address - Phone:513-979-6998
Mailing Address - Fax:513-979-6990
Practice Address - Street 1:3136 MADISON RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45209
Practice Address - Country:US
Practice Address - Phone:513-979-6998
Practice Address - Fax:513-979-6990
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-15
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty