Rasche Pediatric Dentistry, Llc

LBN: Southern Indiana Pediatric Dentistry, Llc
Rasche Pediatric Dentistry, Llc is an health care organization with primary practice located at 828 S Auto Mall Rd , Bloomington IN 47401-5430. The organization recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as the primary health care specialty. Southern Indiana Pediatric Dentistry, Llc can be contacted via phone (812) 333-5437, or through Rasche, Matthew L via phone (812) 661-0612.

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
Authorized official contact:
Name: Rasche, Matthew L D.D.S., M.S.D.
Phone: (812) 661-0612

Health care specialties

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

Profile Details

NPI number 1356634471
LBN Legal business name Southern Indiana Pediatric Dentistry, Llc
DBA Doing business as Rasche Pediatric Dentistry, Llc
Authorized official Rasche, Matthew L D.D.S., M.S.D.
Entity Organization
Organization subpart 1 No
Enumeration date May 23rd, 2011
Last updated Nov 22nd, 2011 - about 15 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 1356634471 NPPES
Indiana MEDICAID 201019080

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