Provider Demographics
NPI:1801853544
Name:SEPE, WALTER W (DMD)
Entity Type:Individual
Prefix:DR
First Name:WALTER
Middle Name:W
Last Name:SEPE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:477 E MAIN RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:RI
Mailing Address - Zip Code:02842-5202
Mailing Address - Country:US
Mailing Address - Phone:401-846-6265
Mailing Address - Fax:401-846-1648
Practice Address - Street 1:477 E MAIN RD
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:RI
Practice Address - Zip Code:02842-5202
Practice Address - Country:US
Practice Address - Phone:401-846-6265
Practice Address - Fax:401-846-1648
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI13831223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics