Healthcare Provider Details

I. General information

NPI: 1164524773
Provider Name (Legal Business Name): DAVID REMPEL DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2006
Last Update Date: 05/23/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 LAKE TRAVERSE DR
SISSETON SD
57262
US

IV. Provider business mailing address

11617 ENCANTO LN
COLTON CA
92324-9737
US

V. Phone/Fax

Practice location:
  • Phone: 605-698-7606
  • Fax: 605-742-0182
Mailing address:
  • Phone: 909-240-6079
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number52774
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: