Provider Demographics
NPI:1528813532
Name:PILLA, ASHWINI B (DMD)
Entity type:Individual
Prefix:DR
First Name:ASHWINI
Middle Name:B
Last Name:PILLA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1336 WILD OLIVE DR
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-7477
Mailing Address - Country:US
Mailing Address - Phone:414-719-8831
Mailing Address - Fax:
Practice Address - Street 1:1336 WILD OLIVE DR
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-7477
Practice Address - Country:US
Practice Address - Phone:414-719-8831
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-22
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program