Organization
INDIANA EMERGENCY DENTAL BLOOMINGTON LLC
Active
Other names
Indiana Emergency Dental
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD GARRY DMD (OWNER, DMD)
(317) 979-0078
Entity
Organization
Contact information
Practice address
1600 W BLOOMFIELD RD, BLOOMINGTON, IN 47403-2054
(463) 276-0541
Mailing address
1600 W BLOOMFIELD RD, BLOOMINGTON, IN 47403-2054
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
08/31/2024
Last updated
09/05/2024
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