Martinsville Oral & Maxillofacial Surgery

LBN: Bloomington Oral & Maxillofacial Surgery
Martinsville Oral & Maxillofacial Surgery is an health care organization with primary practice located at 509 State Road 39 Byp S , Martinsville IN 46151-1972. The organization recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as the primary health care specialty. Bloomington Oral & Maxillofacial Surgery can be contacted via phone (765) 352-9700, or through Tate, Scott E via phone (812) 323-9700.

Contact Information

Primary practice address
509 State Road 39 Byp S Martinsville IN 46151-1972
Phone: (765) 352-9700
Fax: (765) 352-9701
Website:
Map and Directions
Authorized official contact:
Name: Tate, Scott E DDS, MS
Phone: (812) 323-9700

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 12010196 Indiana

Profile Details

NPI number 1619268265
LBN Legal business name Bloomington Oral & Maxillofacial Surgery
DBA Doing business as Martinsville Oral & Maxillofacial Surgery
Authorized official Tate, Scott E DDS, MS
Entity Organization
Organization subpart 1 No
Enumeration date Apr 29th, 2011
Last updated Apr 29th, 2011 - about 13 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1619268265 NPPES
Indiana MEDICAID 200448260

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