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1467609875
JEROME MITHCELL
BLOOMINGTON, IL
NPI
1467609875
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: IL 019017536)
Enumeration Date
2008-08-27
Last Update Date
2008-08-27
Business Address
Mr. JEROME MITHCELL DDS
200 W FRONT ST
BLOOMINGTON, IL 61701-5048
Phone number: 309-888-5533
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Mailing Address
Mr. JEROME MITHCELL DDS
PO BOX 6321
BLOOMINGTON, IL 61702-6321
Phone number: 309-310-3273
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