| Jackson Creek Dental | |
|
1124 S College Mall Rd Bloomington IN 47401 | |
| (812) 336-5525 | |
| (812) 332-5520 |
| Full Name | Jackson Creek Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1124 S College Mall Rd, Bloomington, Indiana |
| Authorized Official Name and Position | Ryan David Tschettei (OWNER) |
| Authorized Official Contact | 8123365525 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jackson Creek Dental 1124 S College Mall Rd Bloomington IN 47401 Ph: (812) 336-5525 | Jackson Creek Dental 1124 S College Mall Rd Bloomington IN 47401 Ph: (812) 336-5525 |
| NPI Number | 1295062339 |
|---|---|
| Provider Enumeration Date | 11/11/2009 |
| Last Update Date | 05/17/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295062339 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 12010765 (Indiana) | Primary |
| 1223G0001X | Dentist - General Practice | 12010729 (Indiana) | Secondary |
News Archive
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› Verified 8 days ago
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Jackson Creek Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1124 S College Mall Rd, Bloomington, IN 47401 Phone: 812-336-5525 Fax: 812-322-5520 | |
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