Individual
DR. TODD EDWARD STIPP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
115 E MAIN ST, WORTHINGTON, IN 47471-1602
(812) 875-2988
Mailing address
115 E MAIN ST, WORTHINGTON, IN 47471-1602
(812) 875-2988
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12009046
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12009046
STATE LICENSE NUMBER
IN
Enumeration date
09/22/2006
Last updated
07/09/2007
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