Healthcare Provider Details

I. General information

NPI: 1609996800
Provider Name (Legal Business Name): DR. PATRICK JAN LAAPER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

448 MAIN ST
COSHOCTON OH
43812-1276
US

IV. Provider business mailing address

448 MAIN ST
COSHOCTON OH
43812-1276
US

V. Phone/Fax

Practice location:
  • Phone: 740-622-5774
  • Fax:
Mailing address:
  • Phone: 740-622-5774
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number20858
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: