Individual
MR. RYAN DAVID TSCHETTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1124 S COLLEGE MALL RD, BLOOMINGTON, IN 47401
(812) 336-5525
(812) 332-5520
Mailing address
1124 S COLLEGE MALL RD, BLOOMINGTON, IN 47401-6178
(812) 336-5525
(812) 332-5520
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
12010765A
IN
1223G0001X
General Practice Dentistry
Primary
12010765A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200974140A
—
IN
Enumeration date
10/16/2006
Last updated
05/17/2018
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