Bautista, Philippe B
Bautista, Philippe B is an sole proprietor health care provider with primary practice located at 434 Patrol Rd Unit 210 , Jeffersonville IN 47130-7718. He recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as his primary health care specialty. Bautista, Philippe B can be contacted via phone (812) 582-7255.Contact Information
Primary practice address
434 Patrol Rd Unit 210
Jeffersonville IN 47130-7718
Phone: (812) 582-7255
Fax: (812) 975-7255
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Pediatric Dentistry | 1223P0221X | 12010902A | Indiana |
| Dental Providers / Pediatric Dentistry | 1223P0221X | 7875 | Kentucky |
Profile Details
| NPI number | 1053423301 |
|---|---|
| LBN Legal business name | Bautista, Philippe B |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 31st, 2006 |
| Last updated | Dec 6th, 2023 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1053423301 | NPPES |
| Kentucky | MEDICAID | 60002904 | |
| Kentucky | Other | 9177122 |
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