Healthcare Provider Details

I. General information

NPI: 1114811668
Provider Name (Legal Business Name): KILIE JO PLETCHER DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KILIE JO ROCK

II. Dates (important events)

Enumeration Date: 06/06/2025
Last Update Date: 06/06/2025
Certification Date: 04/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

716 ADAIR AVE
ZANESVILLE OH
43701-2843
US

IV. Provider business mailing address

6040 FULTONROSE RD
ROSEVILLE OH
43777-9747
US

V. Phone/Fax

Practice location:
  • Phone: 740-891-9000
  • Fax: 740-891-9001
Mailing address:
  • Phone: 740-583-4075
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number30.028058
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: