Individual
DR. TANEENOP ARAMPHONGPHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
109 N REGENCY DR, BLOOMINGTON, IL 61701-3515
(309) 663-2526
Mailing address
109 N REGENCY DR, BLOOMINGTON, IL 61701-3515
(973) 847-4533
(309) 663-4788
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
019030316
IL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
22DI02755800
NJ
Other
Enumeration date
07/23/2015
Last updated
04/24/2026
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