Organization
PHILIPPE BAUTISTA DMD LLC
Active
Other names
PBJ Kids Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PHILIPPE B BAUTISTA DMD (OWNER)
(502) 744-5442
Entity
Organization
Contact information
Practice address
434 PATROL RD SUITE 210, JEFFERSONVILLE, IN 47130
(812) 582-7255
(812) 975-7255
Mailing address
434 PATROL RD SUITE 210, JEFFERSONVILLE, IN 47130
(812) 582-7255
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
06/26/2023
Last updated
12/06/2023
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