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General NPI Number Information
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NPI Number | 1376665166
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Entity Type | Organization
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Legal Business Name | DAVID L UPPERMAN DDS INC
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Dates
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Enumeration Date | 04/04/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 624 CENTRAL CENTER
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City | CHILLICOTHEE
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State | OH
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Zip | 45601
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Country | US
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Telephone | 740-773-4166
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Fax | 740-773-4167
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Provider Business Mailing Address
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Address Line | PO BOX 202 624 CENTRAL CENTER
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City | CHILLICOTHEE
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State | OH
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Zip | 45601
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Country | US
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Telephone | 740-773-4166
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Fax | 740-773-4167
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DAVID L UPPERMAN
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Credential | DDS
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Telephone | 740-773-4166
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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 | 14481
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License Number State | OH
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