Provider Demographics
NPI:1689636979
Name:RZEPECKI, STEVEN MARK (DDS)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:MARK
Last Name:RZEPECKI
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 1:7565 OFFICE RIDGE CIR
Mailing Address - Street 2:
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55344-3651
Mailing Address - Country:US
Mailing Address - Phone:952-944-2212
Mailing Address - Fax:952-941-2895
Practice Address - Street 1:7565 OFFICE RIDGE CIR
Practice Address - Street 2:
Practice Address - City:EDEN PRAIRIE
Practice Address - State:MN
Practice Address - Zip Code:55344-3651
Practice Address - Country:US
Practice Address - Phone:952-944-2212
Practice Address - Fax:952-941-2895
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND8743122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist