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Organization
PERIODONTAL ASSOCIATES OF BLOOMINGTON
Active
Organization
PERIODONTAL ASSOCIATES OF BLOOMINGTON
Active
Other names
Midwest Dental Specialists
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN VILLANUEVA (OPERATIONS MANAGER)
(630) 532-1063
Entity
Organization
Contact information
Practice address
230 N MORTON ST, BLOOMINGTON, IN 47404-3964
(812) 323-7000
Mailing address
230 N MORTON ST, BLOOMINGTON, IN 47404-3964
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
—
—
Other
Enumeration date
07/29/2025
Last updated
07/29/2025
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