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

Brock Gardner

Individual provider Public Health Dentistry · NPI 1033602883

Brock Gardner is a Public Health Dentistry in Bloomington, Illinois. Licensed in Illinois. Registered with an NPI since 2018.

Licensed in
IL
In the registry since
2018
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Practice location Address checks out

107 S Prospect Rd
Bloomington, IL 61704-4403
Phone: (309) 808-6263
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Public Health Dentistry (primary) Taxonomy 1223D0001X · Licence 019.031653 (IL)

Record details

NPI number1033602883
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJune 6, 2018
Last updated in NPPESJune 6, 2018
Mailing address306 Larkspur Turn, Peachtree City, GA 30269-2210