Provider Demographics
NPI:1538140124
Name:CASPER, RHETT BRANDON (DDS)
Entity Type:Individual
Prefix:DR
First Name:RHETT
Middle Name:BRANDON
Last Name:CASPER
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:PSC 41
Mailing Address - Street 2:PO BOX 4811
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09464-9998
Mailing Address - Country:US
Mailing Address - Phone:01144163-851-5885
Mailing Address - Fax:
Practice Address - Street 1:48FW/PA
Practice Address - Street 2:RAF LAKENHEATH
Practice Address - City:BRANDON
Practice Address - State:SUFFOLK
Practice Address - Zip Code:IP27 9PN
Practice Address - Country:GB
Practice Address - Phone:01144163-852-8800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-10
Last Update Date:2008-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5674907-99211223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice