Healthcare Provider Details

I. General information

NPI: 1245368711
Provider Name (Legal Business Name): WILLIAM JOHN AIPPERSBACH D.M.D., M.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/28/2007
Last Update Date: 07/17/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

610 N MILLS AVE STE 210
ORLANDO FL
32803-7113
US

IV. Provider business mailing address

610 N MILLS AVE STE 210
ORLANDO FL
32803-7113
US

V. Phone/Fax

Practice location:
  • Phone: 407-423-7667
  • Fax: 407-425-8629
Mailing address:
  • Phone: 407-423-7667
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License NumberDN16516
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number2478
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: