# BEDFORD DENTAL CARE, PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1093825135
- **Authorized official:** DR. COURTNEY JILL BLACKWELL DMD (V-PRESIDENT)
- **Authorized official phone:** (812) 279-6455

## Contact information

- **Practice address:** 2906 EVERGREEN DR, BEDFORD, IN 47421-5288
- **Practice address phone:** (812) 279-6455
- **Practice address fax:** (812) 279-0130
- **Mailing address:** 2906 EVERGREEN DR, BEDFORD, IN 47421-5288
- **Mailing address phone:** (812) 279-6455
- **Mailing address fax:** (812) 279-0130

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 12010140 | IN | Yes |

## Other

- **Enumeration date:** 08/30/2006
- **Last updated:** 08/22/2020