Provider Demographics
NPI:1225161789
Name:RAUPPLE, MARTIN CARL (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:CARL
Last Name:RAUPPLE
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 1:6715 TIPPECANOE RD STE E102
Mailing Address - Street 2:
Mailing Address - City:CANFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44406-9183
Mailing Address - Country:US
Mailing Address - Phone:330-702-9000
Mailing Address - Fax:330-702-9033
Practice Address - Street 1:6715 TIPPECANOE RD STE E102
Practice Address - Street 2:
Practice Address - City:CANFIELD
Practice Address - State:OH
Practice Address - Zip Code:44406-9183
Practice Address - Country:US
Practice Address - Phone:330-702-9000
Practice Address - Fax:330-702-9033
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH146321223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice