Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

100 South Bloomfield Professional, LLC

Organization General Practice Dentistry · NPI 1912519067

100 South Bloomfield Professional, LLC is a General Practice Dentistry in Bloomfield, New Mexico. Registered with an NPI since 2020.

In the registry since
2020
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

100 S 1st St
Bloomfield, NM 87413-6242
Phone: (505) 632-3344
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X

Record details

NPI number1912519067
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Peter Grumbos — Owner · (505) 632-3344
Other names Sundance Dental Care Of Bloomfield
NPI enumeratedAugust 20, 2020
Last updated in NPPESAugust 20, 2020
Certification dateAugust 20, 2020
Mailing address100 S 1st St, Bloomfield, NM 87413-6242

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