Provider Demographics
NPI:1629237573
Name:TSIAMPAS, PETER BILL (DDS)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:BILL
Last Name:TSIAMPAS
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 1:3827 SOUTH 108TH STREET
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53228-1336
Mailing Address - Country:US
Mailing Address - Phone:414-327-7777
Mailing Address - Fax:
Practice Address - Street 1:3827 SOUTH 108TH STREET
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:WI
Practice Address - Zip Code:53228-1336
Practice Address - Country:US
Practice Address - Phone:414-327-7777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-05
Last Update Date:2008-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5634015122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist