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General NPI Number Information
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NPI Number | 1306937636
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Entity Type | Individual
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Provider Name | RICHARD E SIPES DDS
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Gender | Male
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Dates
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Enumeration Date | 09/28/2006
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Last Update Date | 01/05/2022
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Provider Practice Location Address
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Address Line | 310 W ELM ST
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City | ATHENS
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State | AL
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Zip | 35611-4802
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Country | US
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Telephone | 256-262-0200
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Fax |
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Provider Business Mailing Address
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Address Line | 130 DOGWOOD RIDGE DR
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City | NEW MARKET
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State | AL
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Zip | 35761-7690
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Country | US
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Telephone | 360-904-4713
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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 | D.6853-C
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License Number State | AL
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