Provider Demographics
NPI:1356552699
Name:CIEPLAK, PATRICK S (DDS)
Entity type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:S
Last Name:CIEPLAK
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6265 CRAIN HWY
Mailing Address - Street 2:
Mailing Address - City:LA PLATA
Mailing Address - State:MD
Mailing Address - Zip Code:20646-4266
Mailing Address - Country:US
Mailing Address - Phone:301-609-9999
Mailing Address - Fax:240-898-1842
Practice Address - Street 1:6265 CRAIN HWY
Practice Address - Street 2:
Practice Address - City:LA PLATA
Practice Address - State:MD
Practice Address - Zip Code:20646-4266
Practice Address - Country:US
Practice Address - Phone:301-609-9999
Practice Address - Fax:240-898-1842
Is Sole Proprietor?:No
Enumeration Date:2007-05-25
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD8263122300000X
VA1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Not Answered1223G0001XDental ProvidersDentistGeneral Practice