Provider Demographics
NPI:1407062987
Name:PIKARSKI, JEANETTE D (DMD)
Entity Type:Individual
Prefix:DR
First Name:JEANETTE
Middle Name:D
Last Name:PIKARSKI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:100 HIGHLANDS DR
Mailing Address - Street 2:SUITE 304
Mailing Address - City:LITITZ
Mailing Address - State:PA
Mailing Address - Zip Code:17543-7693
Mailing Address - Country:US
Mailing Address - Phone:717-626-8282
Mailing Address - Fax:717-626-6446
Practice Address - Street 1:100 HIGHLANDS DR
Practice Address - Street 2:SUITE 304
Practice Address - City:LITITZ
Practice Address - State:PA
Practice Address - Zip Code:17543-7693
Practice Address - Country:US
Practice Address - Phone:717-626-8282
Practice Address - Fax:717-626-6446
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PADS029808L1223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PADS029808LOtherDENTAL LICENSE
PA36-4492869OtherTIN