Organization
NORTH VERNON FAMILY DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIPESH SITARAM DDS (OWNER)
(812) 342-9666
Entity
Organization
Contact information
Practice address
623 N STATE ST, NORTH VERNON, IN 47265-1043
(812) 346-6884
(812) 346-1717
Mailing address
623 N STATE ST, NORTH VERNON, IN 47265-1043
(812) 346-6884
(812) 346-1717
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12012474A
IN
Other
Enumeration date
05/31/2016
Last updated
05/31/2016
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