Organization
BLOOMINGTON DENTAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RYAN D TSCHETTER D.D.S. (DENTIST)
(812) 323-1530
Entity
Organization
Contact information
Practice address
1600 W BLOOMFIELD RD, BLOOMINGTON, IN 47403-2054
(812) 323-1530
Mailing address
1600 W BLOOMFIELD RD, BLOOMINGTON, IN 47403-2054
(812) 323-1530
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12010765
IN
Other
Enumeration date
05/16/2006
Last updated
08/22/2020
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