Affordable Dentures & Implants - Bloomington V, P.C.
Dentist, General Practice in Bloomington, IN. Organization (NPI-2).
NPI number1750073409
StatusActive
Last updated in NPPESMay 22, 2023
Details
- NPI
- 1750073409
- Entity type
- Organization (NPI-2)
- Legal business name
- Affordable Dentures & Implants - Bloomington V, P.C.
- Organization subpart
- No
- Enumeration date
- May 22, 2023
- Certification date
- May 10, 2023
- Last updated
- May 22, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | – | – | Yes |
Other names
- Affordable Dentures & Implants - Bloomington (Doing Business As)
Practice location
3800 W Industrial BlvdBloomington, IN 47403-5139
Phone 812-339-9899
Mailing address
3800 W Industrial BlvdBloomington, IN 47403-5139
Phone 812-339-9899
Authorized official
Sarosh Shamsi
Practice Owner
8123399899
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