Provider Demographics
NPI:1366591422
Name:PEEPLES, ALPHONSO (DDS)
Entity type:Individual
Prefix:DR
First Name:ALPHONSO
Middle Name:
Last Name:PEEPLES
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:PO BOX 188
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29731-6188
Mailing Address - Country:US
Mailing Address - Phone:803-329-3636
Mailing Address - Fax:803-817-1785
Practice Address - Street 1:172 SO CHERRY RD
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-3400
Practice Address - Country:US
Practice Address - Phone:803-329-3636
Practice Address - Fax:803-817-1785
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2012-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2678122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCZ26785Medicaid