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Bloomington Oral Surgery
Oral and Maxillofacial Surgery (Dentist) in Bloomington, Indiana
NPI 1891350575

Bloomington Oral Surgery is a Oral and Maxillofacial Surgery (Dentist) based in Bloomington, IN and is specialized in Oral and Maxillofacial Surgery. Bloomington Oral Surgery practices in Bloomington, IN. The NPI Number for Bloomington Oral Surgery is 1891350575 and holds a License No. (Indiana).

The current practice location address for Bloomington Oral Surgery is 1116 S College Mall Rd, Bloomington, IN and can be reached out via phone at 812-332-2204 and via fax at 812-332-9095. You can also correspond with Bloomington Oral Surgery through the mailing address at 1116 S COLLEGE MALL RD, BLOOMINGTON, IN - 47401-6178 (mailing address contact number: 812-332-2204).

Location: 1116 S College Mall Rd, Bloomington, IN, 47401-6178
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1891350575
Provider Name
Bloomington Oral Surgery
Credential
Provider Entity Type
Organization
Address
1116 S College Mall Rd, Bloomington, IN, 47401-6178
Phone Number
812-332-2204
Fax Number
812-332-9095
Provider Enumeration Date
05/07/2019
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1164475323 05 IN
institution
Provider Business Practice Location Address Details
Address
1116 S College Mall Rd
City
Bloomington
State
Indiana
Zip
47401-6178
Phone Number
812-332-2204
Fax Number
812-332-9095
person
Provider Business Mailing Address Details
Address
1116 S College Mall Rd
City
Bloomington
State
Indiana
Zip
47401-6178
Phone Number
812-332-2204
Fax Number
812-332-9095
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Oral and Maxillofacial Surgery
Taxonomy
1223S0112X
License No.
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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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