JACKSON CREEK DENTAL NPI 1295062339

NPI Information

JACKSON CREEK DENTAL is a general practice dentist in Bloomington, IN. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. JACKSON CREEK DENTAL NPI is 1295062339. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1124 S COLLEGE MALL RD
BLOOMINGTON, IN
ZIP 47401
Phone: (812) 336-5525
Fax: (812) 332-5520

The provider's authorized official is Ryan David Tschettei .
The authorized official title is Owner and has the following contact phone number (812) 336-5525.

The enumeration date for this NPI number is 11/11/2009 and was last updated on 5/17/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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