Provider Demographics
NPI:1255952933
Name:NB DENTAL
Entity type:Organization
Organization Name:NB DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:DIPILLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-242-3444
Mailing Address - Street 1:51160 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:NEW BALTIMORE
Mailing Address - State:MI
Mailing Address - Zip Code:48047-2159
Mailing Address - Country:US
Mailing Address - Phone:586-725-9321
Mailing Address - Fax:586-725-5108
Practice Address - Street 1:51160 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:NEW BALTIMORE
Practice Address - State:MI
Practice Address - Zip Code:48047-2159
Practice Address - Country:US
Practice Address - Phone:586-725-9321
Practice Address - Fax:586-725-5108
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-04
Last Update Date:2020-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental