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General NPI Number Information
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NPI Number | 1558454942
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Entity Type | Organization
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Legal Business Name | DR. KVITKO & ASSOCIATES
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Dates
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Enumeration Date | 09/30/2006
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Last Update Date | 06/18/2013
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Provider Practice Location Address
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Address Line | 4308 N HIGH ST
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City | COLUMBUS
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State | OH
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Zip | 43214-2610
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Country | US
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Telephone | 614-262-9588
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Fax | 614-262-4159
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Provider Business Mailing Address
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Address Line | 4308 N HIGH ST
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City | COLUMBUS
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State | OH
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Zip | 43214-2610
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Country | US
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Telephone | 614-262-9588
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Fax | 614-262-4159
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. MARIJANE KIPP
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Credential |
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Telephone | 614-262-9588
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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 | 16442
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License Number State | OH
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