Optim Dental Bloomington Llc | |
401 N Veterans Pkwy Ste 4 Bloomington IL 61704-7716 | |
(217) 971-3432 | |
Not Available |
Full Name | Optim Dental Bloomington Llc |
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Speciality | Dentist |
Location | 401 N Veterans Pkwy Ste 4, Bloomington, Illinois |
Authorized Official Name and Position | Mindy Schmacht (OFFICE MANAGER) |
Authorized Official Contact | 2179713432 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Optim Dental Bloomington Llc 401 N Veterans Pkwy Ste 4 Bloomington IL 61704-7716 Ph: (217) 971-3432 | Optim Dental Bloomington Llc 401 N Veterans Pkwy Ste 4 Bloomington IL 61704-7716 Ph: (217) 971-3432 |
NPI Number | 1902251911 |
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Provider Enumeration Date | 04/27/2016 |
Last Update Date | 04/27/2016 |
Identifier | Type | State | Issuer |
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1902251911 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | 019.0228802 (Illinois) | Primary |
122300000X | Dentist | 019.030202 (Illinois) | Secondary |
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