Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Brock Gardner

Individual provider Public Health Dentistry · NPI 1033602883

Brock Gardner is a Public Health Dentistry in Bloomington, Illinois. Licensed in Illinois. Registered with an NPI since 2018.

Licensed in
IL
In the registry since
2018
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Practice location Address checks out

107 S Prospect Rd
Bloomington, IL 61704-4403
Phone: (309) 808-6263
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Public Health Dentistry (primary) Taxonomy 1223D0001X · Licence 019.031653 (IL)

Record details

NPI number1033602883
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJune 6, 2018
Last updated in NPPESJune 6, 2018