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General NPI Number Information
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NPI Number | 1336178854
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Entity Type | Individual
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Provider Name | STEVEN L. PINE D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 06/30/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1395 E DUBLIN GRANVILLE RD SUITE # 404
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City | COLUMBUS
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State | OH
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Zip | 43229-3314
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Country | US
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Telephone | 614-885-0323
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Fax | 614-885-2544
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Provider Business Mailing Address
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Address Line | 6378 BUSCH BLVD APT. # 397
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City | COLUMBUS
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State | OH
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Zip | 43229-1813
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Country | US
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Telephone | 614-430-8485
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 17819
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License Number State | OH
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