SOUTHERN INDIANA PEDIATRIC DENTISTRY LLC NPI 1356634471

NPI Information

SOUTHERN INDIANA PEDIATRIC DENTISTRY, LLC is a pediatric dentistry dentist in Bloomington, IN. The provider is an age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. SOUTHERN INDIANA PEDIATRIC DENTISTRY, LLC NPI is 1356634471. The provider is registered as an organization entity type and is a single specialty group.
The provider Former Legal Business Name Is Rasche Pediatric Dentistry, Llc.

The provider's business location address is:

828 S AUTO MALL RD
BLOOMINGTON, IN
ZIP 47401-430
Phone: (812) 333-5437
Fax: (812) 333-6305

The provider's authorized official is Matthew L Rasche .
The authorized official title is Owner/member and has the following contact phone number (812) 661-0612.

The enumeration date for this NPI number is 5/23/2011 and was last updated on 11/22/2011.

Taxonomy Codes

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Other Identifiers

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