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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