| Iidsm Bloomington Llc | |
|
2309 E Empire St 500 Bloomington IL 61704-8636 | |
| (309) 319-6568 | |
| Not Available |
| Full Name | Iidsm Bloomington Llc |
|---|---|
| Speciality | Dentist |
| Location | 2309 E Empire St, Bloomington, Illinois |
| Authorized Official Name and Position | Cailin Spencer (ACCOUNTS RECEIVABLE MANAGER) |
| Authorized Official Contact | 3092431341 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Iidsm Bloomington Llc 11825 State Route 40 Suite 100 Dunlap IL 61525-8842 Ph: (309) 243-1341 | Iidsm Bloomington Llc 2309 E Empire St 500 Bloomington IL 61704-8636 Ph: (309) 319-6568 |
| NPI Number | 1366710410 |
|---|---|
| Provider Enumeration Date | 12/05/2011 |
| Last Update Date | 05/16/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366710410 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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