Pivonka, Timothy M

Pivonka, Timothy M is an individual health care provider with primary practice located at 361 Grant Ave , Junction City KS 66441-4201. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Pivonka, Timothy M can be contacted via phone (785) 238-4711.

Contact Information

Primary practice address
361 Grant Ave Junction City KS 66441-4201
Phone: (785) 238-4711
Fax: (785) 238-4260
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 60329 Kansas

Profile Details

NPI number 1609842061
LBN Legal business name Pivonka, Timothy M
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 27th, 2006
Last updated Nov 15th, 2007 - about 17 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1609842061 NPPES
Kansas Other 117182 BLUE CROSS/BLUE SHIELD
Kansas MEDICAID 0008976 BLUE CROSS/BLUE SHIELD

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