Provider Demographics
NPI:1952461733
Name:KNIPPLER, ARTHUR C (DMD)
Entity Type:Individual
Prefix:
First Name:ARTHUR
Middle Name:C
Last Name:KNIPPLER
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:PO BOX 155
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH CENTER
Mailing Address - State:VT
Mailing Address - Zip Code:05061-0155
Mailing Address - Country:US
Mailing Address - Phone:802-728-5533
Mailing Address - Fax:
Practice Address - Street 1:3283 VERMONT ROUTE 66
Practice Address - Street 2:
Practice Address - City:RANDOLPH CENTER
Practice Address - State:VT
Practice Address - Zip Code:05061-0155
Practice Address - Country:US
Practice Address - Phone:802-728-5533
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT1230122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VTOVN1207Medicaid