Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 9972 | MD |
NPI | 1003926841 |
---|---|
Provider Name | Dr. Peter John Trepper |
First Address | Frederick, MD 21701 |
Second Address | Frederick, MD 21701 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2006 |
Last Update Date | 08/07/2007 |