SOUTH CENTRAL ORAL & MAXILLOFACIAL SURGERY, LLC
Organization (NPI-2)
Active
Dentist, Oral and Maxillofacial Surgery
Provider Information
- NPI Number
1760461339- Provider Type
- Organization / Facility (NPI-2)
- Status
- Active
Contact & Location
- Address
- 2911 E COVENANTER DR SUITE B, BLOOMINGTON, IN, 474016320
- Phone
- (812) 333-2614
- Fax
- (812) 333-4594
Specialties & Taxonomies
Dentist, Oral and Maxillofacial Surgery
Primary License: IN #12008000/12009582