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1366710410
IIDSM BLOOMINGTON LLC
BLOOMINGTON, IL
NPI
1366710410
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Entity Type
Organization
Authorized Contact
CAILIN SPENCER
Accounts Receivable Manager
309-243-1341
Organization Subpart ?
No
Primary Taxonomy
122300000X Dentist
Enumeration Date
2011-12-05
Last Update Date
2012-05-16
Business Address
IIDSM BLOOMINGTON LLC
2309 E EMPIRE ST 500
BLOOMINGTON, IL 61704-8636
Phone number: 309-319-6568
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Mailing Address
IIDSM BLOOMINGTON LLC
11825 STATE ROUTE 40 SUITE 100
DUNLAP, IL 61525-8842
Phone number: 309-243-1341
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