Organization
PRITCHARD JASTREMSKI DENTAL ASSOC. LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KELLY ANDREW JASTREMSKI DDS (OWNER MANAGER)
(812) 339-2811
Entity
Organization
Contact information
Practice address
1550 S LIBERTY DR, BLOOMINGTON, IN 47403-5167
(812) 339-2811
(812) 961-0746
Mailing address
1550 S LIBERTY DR, BLOOMINGTON, IN 47403-5167
(812) 339-2811
(812) 961-0746
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12009671
IN
Other
Enumeration date
04/06/2007
Last updated
08/22/2020
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