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South Central Oral & Maxillofacial Surgery, Llc
Oral and Maxillofacial Surgery (Dentist) in Bloomington, Indiana
NPI 1760461339

South Central Oral & Maxillofacial Surgery, Llc is a Oral and Maxillofacial Surgery (Dentist) based in Bloomington, IN and is specialized in Oral and Maxillofacial Surgery. South Central Oral & Maxillofacial Surgery, Llc practices in Bloomington, IN. The NPI Number for South Central Oral & Maxillofacial Surgery, Llc is 1760461339 and holds a License No. 12008000/12009582 (Indiana).

The current practice location address for South Central Oral & Maxillofacial Surgery, Llc is 2911 E Covenanter Dr, Bloomington, IN and can be reached out via phone at 812-333-2614 and via fax at 812-333-4594.

Location: 2911 E Covenanter Dr, Bloomington, IN, 47401-6320
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1760461339
Provider Name
South Central Oral & Maxillofacial Surgery, Llc
Credential
Provider Entity Type
Organization
Address
2911 E Covenanter Dr, Bloomington, IN, 47401-6320
Phone Number
812-333-2614
Fax Number
812-333-4594
Provider Enumeration Date
01/12/2006
Last Update Date
03/08/2024
institution
Provider Business Practice Location Address Details
Address
2911 E Covenanter Dr
City
Bloomington
State
Indiana
Zip
47401-6320
Phone Number
812-333-2614
Fax Number
812-333-4594
person
Provider Business Mailing Address Details
Address
2911 E Covenanter Dr
City
Bloomington
State
Indiana
Zip
47401-6320
Phone Number
812-333-2614
Fax Number
812-333-4594
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Oral and Maxillofacial Surgery
Taxonomy
1223S0112X
License No.
12008000/12009582 (Indiana)
Definition
The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
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