Bloomington Oral & Maxillofacial Surgery Group
Bloomington Oral & Maxillofacial Surgery Group is an Oral & Maxillofacial Surgery (D.M.D.) in Bloomington, Indiana. Licensed in Indiana. Registered with an NPI since 2007.
- Licensed in
- IN
- In the registry since
- 2007
Practice location Address checks out
637 S Walker St Ste 1Bloomington, IN 47403-2154
Phone: (812) 323-9700
Fax: (812) 323-9701
Show map & directions
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Oral & Maxillofacial Surgery (D.M.D.) (primary) | Taxonomy 204E00000X · Licence IN12010196A (IN) |
|---|
Record details
| NPI number | 1386762318 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Scott Tate — Doctor President · (812) 323-9700 |
| NPI enumerated | March 27, 2007 |
| Last updated in NPPES | August 22, 2020 |
| Mailing address | 637 S Walker Street, Suite 1, Bloomington, IN 47403-2154 |