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Organization
PRITCHARD JASTREMSKI DENTAL ASSOC. LLC
Active
Organization
PRITCHARD JASTREMSKI DENTAL ASSOC. LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KELLY ANDREW JASTREMSKI DDS (OWNER MANAGER)
(812) 339-2811
Entity
Organization
Contact information
Practice address
1550 S LIBERTY DR, BLOOMINGTON, IN 47403-5167
(812) 339-2811
(812) 961-0746
Mailing address
1550 S LIBERTY DR, BLOOMINGTON, IN 47403-5167
(812) 339-2811
(812) 961-0746
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12009671
IN
Other
Enumeration date
04/06/2007
Last updated
08/22/2020
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