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Individual
MONTE ROSCOE EPPICH
Active
Individual
MONTE ROSCOE EPPICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D3548
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010152980
BLUE SHIELD
ID
01
—
60498
BLUE CROSS
ID
Enumeration date
03/18/2008
Last updated
03/18/2008
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