Provider Demographics
NPI:1255378766
Name:DOUGLAS P. CLEPPER DMD PC
Entity type:Organization
Organization Name:DOUGLAS P. CLEPPER DMD PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUMANS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-738-8070
Mailing Address - Street 1:3553 WHEELER RD
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30909-6500
Mailing Address - Country:US
Mailing Address - Phone:706-738-8070
Mailing Address - Fax:706-733-0543
Practice Address - Street 1:3553 WHEELER RD
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30909-6500
Practice Address - Country:US
Practice Address - Phone:706-738-8070
Practice Address - Fax:706-733-0543
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty