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

South Central Oral & Maxillofacial Surgery, LLC

Organization Oral and Maxillofacial Surgery (Dentist) · NPI 1760461339

South Central Oral & Maxillofacial Surgery, LLC is an Oral and Maxillofacial Surgery (Dentist) in Bloomington, Indiana. Licensed in Indiana. Registered with an NPI since 2006.

Licensed in
IN
In the registry since
2006
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

2911 E Covenanter Dr Ste B
Bloomington, IN 47401-6320
Phone: (812) 333-2614
Fax: (812) 333-4594
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Oral and Maxillofacial Surgery (Dentist) (primary) Taxonomy 1223S0112X · Licence 12008000/12009582 (IN)

Record details

NPI number1760461339
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Timothy Pliske — Owner · (812) 333-2614
NPI enumeratedJanuary 12, 2006
Last updated in NPPESAugust 22, 2020
Mailing address2911 E Covenanter Dr, Suite B, Bloomington, IN 47401-6320

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