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General NPI Number Information
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NPI Number | 1275871741
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Entity Type | Organization
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Legal Business Name | DAVID R. CLEPPE, D.D.S., PC
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Dates
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Enumeration Date | 01/17/2013
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 16 S SAINT JOSEPH AVE
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City | NILES
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State | MI
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Zip | 49120-2847
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Country | US
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Telephone | 269-240-0720
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Fax |
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Provider Business Mailing Address
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Address Line | 8425 WOODFIELD CROSSING BLVD SUITE 100
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City | INDIANAPOLIS
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State | IN
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Zip | 46240-7315
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DAVID R. CLEPPE
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Credential | D.D.S.
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Telephone | 269-240-0720
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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 | 12011205A
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License Number State | IN
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