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Individual

DR. TRACY DIRK SAPP

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
416 W CAMP ST, LEBANON, IN 46052-1799
(765) 483-4469
(765) 483-4495
Mailing address
1716 HARTFORD ST, LAFAYETTE, IN 47904-2138
(765) 742-1567
(765) 429-2700

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12009042
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100186680A
IN
Enumeration date
05/02/2006
Last updated
05/09/2022
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