Provider Demographics
NPI:1720482417
Name:TIMOTHY A. KERPER, D.M.D., P.C.
Entity Type:Organization
Organization Name:TIMOTHY A. KERPER, D.M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / ENDODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:A
Authorized Official - Last Name:KERPER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:256-237-8174
Mailing Address - Street 1:626A LEIGHTON AVE
Mailing Address - Street 2:
Mailing Address - City:ANNISTON
Mailing Address - State:AL
Mailing Address - Zip Code:36207-5744
Mailing Address - Country:US
Mailing Address - Phone:256-237-8174
Mailing Address - Fax:256-237-8805
Practice Address - Street 1:626A LEIGHTON AVE
Practice Address - Street 2:
Practice Address - City:ANNISTON
Practice Address - State:AL
Practice Address - Zip Code:36207-5744
Practice Address - Country:US
Practice Address - Phone:256-237-8174
Practice Address - Fax:256-237-8805
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-09
Last Update Date:2014-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty