| NPI | 1851628903 |
|---|---|
| Doing Business As | BLOOMINGTON FAMILY DENTAL |
| Entity Type | Organization |
| Authorized Contact | RYAN EDWARD KLOBOVES Dentist 812-824-1600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IN 12010746B) |
| Enumeration Date | 2009-11-11 |
| Last Update Date | 2009-11-11 |