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General NPI Number Information
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NPI Number | 1568042604
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Entity Type | Organization
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Legal Business Name | WALTER N. PEAVLER, DMD, PLLC
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Dates
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Enumeration Date | 04/13/2021
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Last Update Date | 04/13/2021
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Provider Practice Location Address
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Address Line | 198 REDWING DR
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City | WINCHESTER
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State | KY
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Zip | 40391-1674
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Country | US
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Telephone | 859-744-0320
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Fax |
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Provider Business Mailing Address
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Address Line | 198 REDWING DR
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City | WINCHESTER
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State | KY
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Zip | 40391-1674
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Country | US
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Telephone | 859-744-0320
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. WALTER PEAVLER
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Credential |
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Telephone | 502-682-4807
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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 |
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License Number State |
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