Organization
LIFETIME DENTAL CARE OF INDIANA, PC
Active
Other names
Landmark Family Dental Care
Organization subpart
No
Provider details
NPI number
Authorized official
ALL CREDENTIALING (CREDENTIALING)
(217) 540-2100
Entity
Organization
Contact information
Practice address
1320 W BLOOMFIELD RD, BLOOMINGTON, IN 47403-2001
(812) 339-7743
(812) 339-7383
Mailing address
1320 W BLOOMFIELD RD, BLOOMINGTON, IN 47403-2001
(812) 339-7743
(812) 339-7383
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
05/03/2007
Last updated
11/10/2022
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