Provider Demographics
NPI:1669521381
Name:PIEPER, DAVID JAMES (DDS)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:JAMES
Last Name:PIEPER
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 1:701 W PARK AVE
Mailing Address - Street 2:P.O. BOX 157
Mailing Address - City:KIEL
Mailing Address - State:WI
Mailing Address - Zip Code:53042-1717
Mailing Address - Country:US
Mailing Address - Phone:920-894-2626
Mailing Address - Fax:920-894-2057
Practice Address - Street 1:701 W PARK AVE
Practice Address - Street 2:#157
Practice Address - City:KIEL
Practice Address - State:WI
Practice Address - Zip Code:53042-1717
Practice Address - Country:US
Practice Address - Phone:920-894-2626
Practice Address - Fax:920-894-2057
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI37891223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice