MEDICARE: DR. DONALD ALLAN PEPPER D.D.S.

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	1223G0001X	General Practice Dentistry	27352	CA

General Provider Information

NPI Number	:	1750434726
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DONALD ALLAN PEPPER D.D.S.

Provider Business Mailing Address
First Line	:	1660 WILLOW ST STE 7
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95125-5101
Country	:	US
Telephone Number	:	408-266-4571
Fax Number	:	408-267-9016

Provider Business Practice Location Address
First Line	:	1660 WILLOW ST STE 7
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95125-5101
Country	:	US
Telephone Number	:	408-266-4571
Fax Number	:	408-267-9016

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

Provider Enumeration Date	:	01/20/2007
Last Update Date	:	10/10/2019

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