Provider Demographics
NPI:1942616941
Name:FAMILY DENTISTRY, P.C.
Entity Type:Organization
Organization Name:FAMILY DENTISTRY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:J
Authorized Official - Last Name:PIEPER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:307-532-4448
Mailing Address - Street 1:2017 CAMPBELL DR
Mailing Address - Street 2:
Mailing Address - City:TORRINGTON
Mailing Address - State:WY
Mailing Address - Zip Code:82240-1527
Mailing Address - Country:US
Mailing Address - Phone:307-532-4448
Mailing Address - Fax:307-532-2391
Practice Address - Street 1:2017 CAMPBELL DR
Practice Address - Street 2:
Practice Address - City:TORRINGTON
Practice Address - State:WY
Practice Address - Zip Code:82240-1527
Practice Address - Country:US
Practice Address - Phone:307-532-4448
Practice Address - Fax:307-532-2391
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-10
Last Update Date:2014-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY672122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty