Organization
BEDFORD DENTAL CARE, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. COURTNEY JILL BLACKWELL DMD (V-PRESIDENT)
(812) 279-6455
Entity
Organization
Contact information
Practice address
2906 EVERGREEN DR, BEDFORD, IN 47421-5288
(812) 279-6455
(812) 279-0130
Mailing address
2906 EVERGREEN DR, BEDFORD, IN 47421-5288
(812) 279-6455
(812) 279-0130
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12010140
IN
Other
Enumeration date
08/30/2006
Last updated
08/22/2020
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