Southern Indiana Pediatric Dentistry, Llc is a Pediatric Dental Clinic in Bloomington, Indiana. It is located at 828 S Auto Mall Rd, Bloomington, IN and its contact number is 812-333-5437. The authorized person for Southern Indiana Pediatric Dentistry, Llc is Matthew L Rasche
who is Owner/member of the clinic and their contact number is 812-661-0612. Other organizations associated with this clinic are Southern Indiana Pediatric Dentistry, Llc, J Keith Roberts Dds Llc, The primary license number for Southern Indiana Pediatric Dentistry, Llc is 12011284A (Pediatric Dentistry) in Indiana. Southern Indiana Pediatric Dentistry, Llc Clinic provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
Complete Clinic Profile:
Southern Indiana Pediatric Dentistry, Llc Clinic speciality, address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointments.
Name:
Southern Indiana Pediatric Dentistry, Llc
Specialization:
Pediatric Dentistry
Clinic Address:
828 S Auto Mall Rd, Bloomington, Indiana, 47401-5430
Phone:
812-333-5437
Fax:
812-333-6305
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints for this clinic are as below. Person's position and contact details are also mentioned below.
Name:
Matthew L Rasche
Position:
Owner/member
Contact Number:
812-661-0612
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details for Southern Indiana Pediatric Dentistry, Llc clinic are as mentioned below.
NPI Number:
1356634471
NPI Enumeration Date:
23 May, 2011
NPI Last Update On:
22 Nov, 2011
Other Associated Organizations:
Other organizations which are associated with this clinic are as mentioned below. These organization share the same address but have similar or different specialization.
Speciality of these organizations are also mentioned below.
Name
Specialization
NPI Number
Southern Indiana Pediatric Dentistry, Llc
Pediatric Dentistry
1356634471
J Keith Roberts Dds Llc
Pediatric Dentistry
1518290550
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Southern Indiana Pediatric Dentistry, Llc are as mentioned below.
Specialization
License Number
State
Status
Pediatric Dentistry
12011284A
Indiana
Primary
Other Medical Identifiers:
Other legacy medical identifiers of the clinic such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
Identifier
Type
State
Issuer
201019080
Medicaid
Indiana
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
Address:
Southern Indiana Pediatric Dentistry, Llc 828 S Auto Mall Rd, Bloomington, Indiana
Zip:
47401-5430
Phone Number:
812-333-5437
Fax Number:
812-333-6305
Patients can reach Southern Indiana Pediatric Dentistry, Llc at 828 S Auto Mall Rd, Bloomington, Indiana or can call to book an appointment on 812-333-5437. Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 11 November, 2024.