Ciepluch, Randy R

Ciepluch, Randy R is an individual health care provider with primary practice located at 3500 W Lisbon Ave , Milwaukee WI 53208-1953. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Ciepluch, Randy R can be contacted via phone (414) 342-0378.

Contact Information

Primary practice address
3500 W Lisbon Ave Milwaukee WI 53208-1953
Fax: (414) 342-1008
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 2260-015 Wisconsin

Profile Details

NPI number 1245221977
LBN Legal business name Ciepluch, Randy R
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 2nd, 2005
Last updated Jul 9th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1245221977 NPPES
Wisconsin MEDICAID 33387500

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