Provider Demographics
NPI:1376692707
Name:CHAPPELLE, EDWARD HENRY JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:HENRY
Last Name:CHAPPELLE
Suffix:JR
Gender:M
Credentials:DDS
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Mailing Address - Street 1:3060 MITCHELLVILLE RD
Mailing Address - Street 2:SUITE 107
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20716-1389
Mailing Address - Country:US
Mailing Address - Phone:301-390-9185
Mailing Address - Fax:301-390-7267
Practice Address - Street 1:3060 MITCHELLVILLE RD
Practice Address - Street 2:SUITE 107
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20716-1389
Practice Address - Country:US
Practice Address - Phone:301-390-9185
Practice Address - Fax:301-390-7267
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2011-10-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MD076761223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice