Organization
BLOOMINGTON FAMILY DENTAL, LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN PETER VAN SCOYOC DDS (PRESIDENT)
(309) 664-0570
Entity
Organization
Contact information
Practice address
908 N HERSHEY RD, SUITE 2, BLOOMINGTON, IL 61704-3730
(309) 664-0570
(309) 664-6612
Mailing address
908 N HERSHEY RD, SUITE 2, BLOOMINGTON, IL 61704-3730
(309) 664-0570
(309) 664-6612
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
IL
Other
Enumeration date
05/03/2007
Last updated
08/22/2020
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