Bloomington Oral Surgery Llc
Oral and Maxillofacial Dental Clinic
857 S Auto Mall Rd, Bloomington
Indiana, 47401-5447
812-332-2204 821-332-9095
Maps & DirectionsBloomington Oral Surgery Llc is a Oral and Maxillofacial Dental Clinic in Bloomington, Indiana. It is located at 857 S Auto Mall Rd, Bloomington, IN and its contact number is 812-332-2204. The authorized person for Bloomington Oral Surgery Llc is Timothy Devitt
who is Owner of the clinic and their contact number is 812-332-2204. The primary license number for Bloomington Oral Surgery Llc is 0652A (Oral and Maxillofacial Surgery) in Indiana.
Bloomington Oral Surgery Llc Clinic deals with the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
Complete Clinic Profile:
Bloomington Oral Surgery Llc Clinic speciality, address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointments.
| Name: | Bloomington Oral Surgery Llc |
| Specialization: | Oral and Maxillofacial Surgery |
| Clinic Address: | 857 S Auto Mall Rd, Bloomington,
Indiana, 47401-5447 |
| Phone: | 812-332-2204 |
| Fax: | 821-332-9095 |
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: | Timothy Devitt |
| Position: | Owner |
| Contact Number: | 812-332-2204 |
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 Bloomington Oral Surgery Llc clinic are as mentioned below.
| NPI Number: | 1841505252 |
| NPI Enumeration Date: | 10 Aug, 2010 |
| NPI Last Update On: | 10 Aug, 2010 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Bloomington Oral Surgery Llc are as mentioned below.
| Specialization | License Number | State | Status | |
| Oral and Maxillofacial Surgery | 0652A | 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 |
| 200809540A | 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: | Bloomington Oral Surgery Llc
857 S Auto Mall Rd,
Bloomington, Indiana |
| Zip: | 47401-5447 |
| Phone Number: | 812-332-2204 |
| Fax Number: | 821-332-9095 |
Patients can reach Bloomington Oral Surgery Llc at
857 S Auto Mall Rd, Bloomington, Indiana or can
call to book an appointment on 812-332-2204.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on
08 December, 2025.