Provider Demographics
NPI:1073649356
Name:ROEPCKE, DWIGHT JEFFREY (DMD)
Entity Type:Individual
Prefix:DR
First Name:DWIGHT
Middle Name:JEFFREY
Last Name:ROEPCKE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:347 GREEN VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047-1128
Mailing Address - Country:US
Mailing Address - Phone:215-860-7333
Mailing Address - Fax:
Practice Address - Street 1:275 N PINE ST
Practice Address - Street 2:SUITE A
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-1621
Practice Address - Country:US
Practice Address - Phone:215-750-1125
Practice Address - Fax:215-750-9580
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS-025072-L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice