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General NPI Number Information
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NPI Number | 1285035444
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Entity Type | Organization
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Legal Business Name | JOHN'E JASPER EPPS, DDS, PLC
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Dates
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Enumeration Date | 09/08/2014
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Last Update Date | 09/08/2014
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Provider Practice Location Address
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Address Line | 9460 AMBERDALE DR SUITE H
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City | NORTH CHESTERFIELD
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State | VA
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Zip | 23236-1259
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Country | US
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Telephone | 804-304-9670
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Fax |
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Provider Business Mailing Address
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Address Line | 19710 SIOUX LN
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City | SOUTH PRINCE GEORGE
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State | VA
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Zip | 23805-8830
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Country | US
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Telephone | 804-304-9670
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOHN'E JASPER EPPS
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Credential | DDS
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Telephone | 804-304-9670
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 0401414327
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License Number State | VA
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