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NPI 1669521381

NPI 1669521381 : DAVID JAMES PIEPER D.D.S. : KIEL, WI

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General NPI Number Information
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    NPI Number           |    1669521381
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    Entity Type          |    Individual 
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    Provider Name        |    DAVID JAMES PIEPER D.D.S.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    01/10/2007
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    701 W PARK AVE #157
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    City                 |    KIEL
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    State                |    WI
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    Zip                  |    53042-1717
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    Country              |    US
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    Telephone            |    920-894-2626
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    Fax                  |    920-894-2057
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Provider Business Mailing Address
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    Address Line         |    701 W PARK AVE P.O. BOX 157
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    City                 |    KIEL
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    State                |    WI
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    Zip                  |    53042-1717
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    Country              |    US
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    Telephone            |    920-894-2626
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    Fax                  |    920-894-2057
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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        |    1223G0001X
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    Taxonomy Name        |    General Practice Dentistry
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    License Number       |    3789
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    License Number State |    WI
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