Provider Demographics
NPI:1760579510
Name:CHAPMAN, PETER LESLIE (DDS, MSD)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:LESLIE
Last Name:CHAPMAN
Suffix:
Gender:M
Credentials:DDS, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 BOULEVARD MOTIF
Mailing Address - Street 2:
Mailing Address - City:BROWNSBURG
Mailing Address - State:IN
Mailing Address - Zip Code:46112
Mailing Address - Country:US
Mailing Address - Phone:317-852-5566
Mailing Address - Fax:317-852-3527
Practice Address - Street 1:18 BOULEVARD MOTIF
Practice Address - Street 2:
Practice Address - City:BROWNSBURG
Practice Address - State:IN
Practice Address - Zip Code:46112
Practice Address - Country:US
Practice Address - Phone:317-852-5566
Practice Address - Fax:317-852-3527
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN120074571223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics