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Organization

JACKSON CREEK DENTAL

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RYAN D TSCHETTER D.D.S. (DENTIST)
(812) 336-5525
Entity
Organization

Contact information

Practice address
1124 S COLLEGE MALL RD, BLOOMINGTON, IN 47401-6178
(812) 336-5525
(812) 322-5520
Mailing address
1124 S COLLEGE MALL RD, BLOOMINGTON, IN 47401-6178
(812) 336-5525
(812) 322-5520

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12010765A
IN

Other

Enumeration date
05/08/2013
Last updated
05/08/2013
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