Rasche, Matthew Lawrence

Rasche, Matthew Lawrence is an individual health care provider with primary practice located at 828 S Auto Mall Rd , Bloomington IN 47401-5430. He recently has 2 registered licenses in different health care specialties including Dental Providers / Dentist, Dental Providers / Pediatric Dentistry. Dental Providers / Pediatric Dentistry is his primary health care specialty. Rasche, Matthew Lawrence can be contacted via phone (812) 333-5437.

Contact Information

Primary practice address
828 S Auto Mall Rd Bloomington IN 47401-5430
Phone: (812) 333-5437
Fax: (812) 333-6305
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 12011284A Indiana
Dental Providers / Pediatric Dentistry 1223P0221X 12011284A Indiana

Profile Details

NPI number 1619102647
LBN Legal business name Rasche, Matthew Lawrence
Credentials D.D.S. M.S.D.
Entity Individual
Sole proprietor 1 No
Enumeration date May 20th, 2009
Last updated Jul 13th, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1619102647 NPPES
Indiana MEDICAID 201019080A

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