Organization
OPTIM DENTAL BLOOMINGTON LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MINDY SCHMACHT (OFFICE MANAGER)
(217) 971-3432
Entity
Organization
Contact information
Practice address
401 N VETERANS PKWY STE 4, BLOOMINGTON, IL 61704-7716
(217) 971-3432
Mailing address
401 N VETERANS PKWY STE 4, BLOOMINGTON, IL 61704-7716
(217) 971-3432
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019.0228802
IL
122300000X
Dentist
019.030202
IL
Other
Enumeration date
04/27/2016
Last updated
04/27/2016
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