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Individual

DR. DIPESH P SITARAM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
3780 W JONATHAN MOORE PIKE STE 180, COLUMBUS, IN 47201-9430
(812) 342-9666
(812) 342-4434
Mailing address
3780 W JONATHAN MOORE PIKE, #180, COLUMBUS, IN 47201-9430
(812) 342-9666
(812) 342-4434

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12010835A
IN
1223P0221X
Pediatric Dentistry
12010835A
IN

Other

Enumeration date
10/25/2006
Last updated
06/19/2017
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