Organization
DMITRIY PIVNIK DDS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DMITRIY PIVNIK D.D.S (OFFICER)
(415) 412-3158
Entity
Organization
Contact information
Practice address
18455 TECHNOLOGY DR, MORGAN HILL, CA 95037-2822
(916) 783-5239
Mailing address
18455 TECHNOLOGY DR, MORGAN HILL, CA 95037-2822
(562) 577-5641
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
100181
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1275991721
—
CA
Enumeration date
09/06/2016
Last updated
10/18/2022
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