Provider Demographics
NPI:1275704694
Name:BLOHM, STEVEN DAVID (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:DAVID
Last Name:BLOHM
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6660 S BROADWAY
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80121
Mailing Address - Country:US
Mailing Address - Phone:303-794-2381
Mailing Address - Fax:
Practice Address - Street 1:209 E MAIN
Practice Address - Street 2:
Practice Address - City:TRINIDAD
Practice Address - State:CO
Practice Address - Zip Code:81082
Practice Address - Country:US
Practice Address - Phone:719-846-0870
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-13
Last Update Date:2008-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6364122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist