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NPI Code Detail

MEDICARE: AJIT V PILLAI DMD

MEDICARE: AJIT V PILLAI DMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223S0112XOral and Maxillofacial Surgery (Dentist)5568WI

General Provider Information

NPI Number : 1285638643
Entity Type Code : Individual
Provider Name (Legal Business Name) : AJIT V PILLAI DMD
Provider Business Mailing Address
First Line : 2100 MILLER PARK WAY
Second Line :
City : WEST MILWAUKEE
State : WI
Zip : 53219-1641
Country : US
Telephone Number : 414-645-4540
Fax Number :
Provider Business Practice Location Address
First Line : 2100 MILLER PARK WAY
Second Line :
City : WEST MILWAUKEE
State : WI
Zip : 53219-1641
Country : US
Telephone Number : 414-645-4540
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/13/2005
Last Update Date : 12/04/2020

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