Provider Demographics
NPI:1174866255
Name:EPP, GARY EUGENE (DDS)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:EUGENE
Last Name:EPP
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 GRANT AVE
Mailing Address - Street 2:
Mailing Address - City:EVELETH
Mailing Address - State:MN
Mailing Address - Zip Code:55734-1524
Mailing Address - Country:US
Mailing Address - Phone:218-744-5440
Mailing Address - Fax:218-744-5441
Practice Address - Street 1:320 GRANT AVE
Practice Address - Street 2:
Practice Address - City:EVELETH
Practice Address - State:MN
Practice Address - Zip Code:55734-1524
Practice Address - Country:US
Practice Address - Phone:218-744-5440
Practice Address - Fax:218-744-5441
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-27
Last Update Date:2013-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN7799122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist