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General NPI Number Information
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NPI Number | 1215597414
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Entity Type | Individual
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Provider Name | MATTHEW KUIPER DDS
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Gender | Male
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Dates
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Enumeration Date | 06/19/2019
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Last Update Date | 03/25/2025
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Provider Practice Location Address
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Address Line | 3857 COOPER ST
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City | JACKSON
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State | MI
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Zip | 49201-7547
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Country | US
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Telephone | 517-780-5760
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Fax |
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Provider Business Mailing Address
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Address Line | 4773 US HIGHWAY 131 N
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City | BOYNE FALLS
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State | MI
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Zip | 49713-9617
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Country | US
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Telephone | 616-914-8353
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 2901600113
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License Number State | MI
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