Provider Demographics
NPI:1336370444
Name:RUPPRECHT, ROBERT D (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:D
Last Name:RUPPRECHT
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:2500 COMO AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55108-1460
Mailing Address - Country:US
Mailing Address - Phone:651-647-2500
Mailing Address - Fax:651-632-8984
Practice Address - Street 1:2500 COMO AVE
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55108-1460
Practice Address - Country:US
Practice Address - Phone:651-647-2500
Practice Address - Fax:651-632-8984
Is Sole Proprietor?:No
Enumeration Date:2009-08-06
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA376011223P0300X, 1223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No1223P0300XDental ProvidersDentistPeriodontics