Healthcare Provider Details

I. General information

NPI: 1053406082
Provider Name (Legal Business Name): ROBERT HEPLER D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

721 S UNION AVE
ALLIANCE OH
44601-2932
US

IV. Provider business mailing address

721 S UNION AVE
ALLIANCE OH
44601-2932
US

V. Phone/Fax

Practice location:
  • Phone: 330-821-0441
  • Fax: 330-821-2549
Mailing address:
  • Phone: 330-821-0441
  • Fax: 330-821-2549

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number14487
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: