| NPI | 1174693220 |
|---|---|
| Other Name | BLOOMINGTON GENTLE DENTIST |
| Entity Type | Organization |
| Authorized Contact | TIM HOAGLAND Executive 502-423-9111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2020-08-22 |