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Bloomington Oral & Maxillofacial Surgery — NPI 1619268265, Martinsville, IN | NPI Central

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NPI 1619268265

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Bloomington Oral & Maxillofacial Surgery

NPI 1619268265 · Oral and Maxillofacial Surgery (Dentist) · Martinsville, IN

Provider details

NPI number: 1619268265
Entity type: Organization
Primary specialty: Oral and Maxillofacial Surgery (Dentist)Dental Providers
Organization subpart: No
Authorized official: Scott Tate, Owner(812) 323-9700
License: 12010196 (IN)

Specialties & taxonomies

Oral and Maxillofacial Surgery (Dentist)Primary1223S0112XLicense 12010196 (IN)
Dental Providers

Practice location

509 State Road 39 Byp S

Martinsville, IN 46151-1972

Phone: (765) 352-9700

Fax: (765) 352-9701

Approximate (ZIP-level) locationGet directions

More IN providers

Mailing address

509 State Road 39 Byp S

Martinsville, IN 46151-1972

Other names (DBA / former)

Doing business as: Martinsville Oral & Maxillofacial Surgery

Registry dates

Enumerated: 2011-04-29
Last updated: 2011-04-29

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.