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General NPI Number Information
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NPI Number | 1992899959
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Entity Type | Organization
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Legal Business Name | BRADLEY R HEPLER DDS PC
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 02/21/2022
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Provider Practice Location Address
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Address Line | 11190 HAYNES BRIDGE RD
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City | ALPHARETTA
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State | GA
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Zip | 30022-4810
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Country | US
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Telephone | 866-687-1992
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Fax |
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Provider Business Mailing Address
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Address Line | 11190 HAYNES BRIDGE RD
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City | ALPHARETTA
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State | GA
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Zip | 30022-4810
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Country | US
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Telephone | 866-687-1992
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | BRADLEY HEPLER
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Credential | DDS
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Telephone | 866-687-1992
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 12465
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License Number State | GA
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