MEDICARE: DR. ROBERT PHILLIP DIPILLA DDS FAGD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	2901015400	MI

General Provider Information

NPI Number	:	1841419561
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT PHILLIP DIPILLA DDS FAGD

Provider Business Mailing Address
First Line	:	600 NORTH OLD WOODWARD AVENUE
Second Line	:	SUITE #201
City	:	BIRMINGHAM
State	:	MI
Zip	:	48009-1318
Country	:	US
Telephone Number	:	248-646-0442
Fax Number	:	248-646-2658

Provider Business Practice Location Address
First Line	:	600 NORTH OLD WOODWARD AVENUE
Second Line	:	SUITE #201
City	:	BIRMINGHAM
State	:	MI
Zip	:	48009-1318
Country	:	US
Telephone Number	:	248-646-0442
Fax Number	:	248-646-2658

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/24/2007
Last Update Date	:	07/08/2007

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