Provider Demographics
NPI:1174672729
Name:OPPERMANN, KARL EDWARD JR (DDS, FAGD)
Entity Type:Individual
Prefix:DR
First Name:KARL
Middle Name:EDWARD
Last Name:OPPERMANN
Suffix:JR
Gender:M
Credentials:DDS, FAGD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1414 GREEN OAK TERRACE CT
Mailing Address - Street 2:
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77339-2960
Mailing Address - Country:US
Mailing Address - Phone:281-358-2711
Mailing Address - Fax:271-358-0860
Practice Address - Street 1:1414 GREEN OAK TERRACE CT
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-2960
Practice Address - Country:US
Practice Address - Phone:281-358-2711
Practice Address - Fax:271-358-0860
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX128751223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice