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General NPI Number Information
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NPI Number | 1720140684
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Entity Type | Organization
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Legal Business Name | DENTISTRY JUST FOR KIDS,P.C.
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Dates
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Enumeration Date | 12/15/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 800 POPLAR ST
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City | TERRE HAUTE
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State | IN
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Zip | 47807-3724
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Country | US
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Telephone | 812-235-6025
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Fax |
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Provider Business Mailing Address
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Address Line | 800 POPLAR ST
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City | TERRE HAUTE
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State | IN
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Zip | 47807-3724
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Country | US
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Telephone | 812-235-6025
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Fax |
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Authorized Official
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Title or Position | OWER
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Name | DR. STEVEN M. PILIPOVICH
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Credential | D.D.S.
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Telephone | 812-234-7322
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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