MEDICARE: DR. ROBERT JOSEPH PEPPETTI DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	DS018601L	PA

General Provider Information

NPI Number	:	1558333989
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT JOSEPH PEPPETTI DMD

Provider Business Mailing Address
First Line	:	PO BOX 193
Second Line	:
City	:	PORTAGE
State	:	PA
Zip	:	15946-0193
Country	:	US
Telephone Number	:	814-736-3600
Fax Number	:

Provider Business Practice Location Address
First Line	:	605 MAIN ST
Second Line	:
City	:	PORTAGE
State	:	PA
Zip	:	15946-1539
Country	:	US
Telephone Number	:	814-736-3600
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/01/2006
Last Update Date	:	07/08/2007

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