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General NPI Number Information
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NPI Number | 1275609646
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Entity Type | Organization
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Legal Business Name | PETER J TSIVITSE JR DDS & ASSOC INC
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Dates
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Enumeration Date | 11/28/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 672 NEEB RD
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City | CINCINNATI
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State | OH
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Zip | 45233
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Country | US
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Telephone | 513-451-5399
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Fax | 513-451-9222
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Provider Business Mailing Address
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Address Line | 672 NEEB RD
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City | CINCINNATI
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State | OH
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Zip | 45233
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Country | US
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Telephone | 513-451-5399
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Fax | 513-451-9222
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Authorized Official
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Title or Position | OWNER
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Name | DR. PETER JOHN TSIVITSE JR.
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Credential | DDS
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Telephone | 513-451-5399
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | OH17565
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License Number State | OH
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