Provider Demographics
NPI:1699757500
Name:PEPPERS, DAVID C (DDS)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:C
Last Name:PEPPERS
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 1:209 MORROW ST N
Mailing Address - Street 2:P.O. BOX 197
Mailing Address - City:MENA
Mailing Address - State:AR
Mailing Address - Zip Code:71953-2514
Mailing Address - Country:US
Mailing Address - Phone:479-394-5920
Mailing Address - Fax:479-394-7273
Practice Address - Street 1:209 MORROW ST N
Practice Address - Street 2:
Practice Address - City:MENA
Practice Address - State:AR
Practice Address - Zip Code:71953-2514
Practice Address - Country:US
Practice Address - Phone:479-394-5920
Practice Address - Fax:479-437-3454
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-16
Last Update Date:2008-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR3444122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist