Provider Demographics
NPI:1447467089
Name:PIPER, JAMES MATSON II (DMD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:MATSON
Last Name:PIPER
Suffix:II
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1227 TIGER PATH
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78251-4059
Mailing Address - Country:US
Mailing Address - Phone:210-509-9012
Mailing Address - Fax:
Practice Address - Street 1:59DTS MRDE
Practice Address - Street 2:2450 PEPPERRELL STREET
Practice Address - City:LACKLAND AFB
Practice Address - State:TX
Practice Address - Zip Code:78236-5345
Practice Address - Country:US
Practice Address - Phone:210-292-7115
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0363361223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics