DR. ROBERT T PECK DMD NPI 1003874140

Dentist (General Practice) in Boise, ID

About ROBERT PECK

Robert Peck is a provider in Boise, ID. The NPI number assigned to this provider is 1003874140. The practitioner's primary taxonomy code is Dentist (1223G0001X). The provider is registered as an individual and their NPI record was last updated 10 years ago. Robert Peck is registered with Medicare.

NPI1003874140 Additional informationCallout TooltipNational Provider Indentifier (NPI)
The 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.
Provider NameDR. ROBERT T PECK DMD
Provider Location Address7480 NORTHVIEW ST BOISE, ID 83704 Additional informationCallout TooltipProvider location address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Mailing Address7480 NORTHVIEW ST BOISE, ID 83704 Additional informationCallout TooltipProvider mailing address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.
GenderMale
NPI Entity TypeIndividual Additional informationCallout TooltipEntity type code
The code describing the type of health care provider that is being assigned an NPI.
Codes are:
1 = (Person): individual human being who furnishes health care;
2 = (Non-person): entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO).
Is Sole Proprietor?N/A
Is Organization Subpart?N/A Additional informationCallout TooltipWhat is a subpart?
Subparts are the components and separate physical locations of organization health care providers. Examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.
Enumeration Date05-01-2006 Additional informationCallout TooltipProvider enumeration date
The date the provider was assigned a unique identifier (assigned an NPI)
Last Update Date07-08-2007 Additional informationCallout TooltipLast update date
The date that a record was last updated or changed.

Business Address

DR. ROBERT T PECK DMD
7480 NORTHVIEW ST
BOISE, ID
ZIP 83704
Phone: (208) 322-2727
Fax: (208) 375-0225
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Mailing Address

DR. ROBERT T PECK DMD
7480 NORTHVIEW ST
BOISE, ID
ZIP 83704
Phone: (208) 322-2727
Fax: (208) 375-0225

Primary Taxonomy

Taxonomy Code1223G0001X Additional informationCallout TooltipPrimary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
ClassificationDentist
TypeDental Providers
SpecializationGeneral Practice
License No.D1835
License StateID
Taxonomy DescriptionA general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Map Location


DR. ROBERT T PECK DMD address is 7480 NORTHVIEW ST BOISE, ID 83704

Other Providers at the same location


The following 2 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1265692321GLEN K STEPHENSON DMD CHARTERED
Organization
Dentist (General Practice)7480 NORTHVIEW ST
BOISE, ID 83704
(208) 375-4041
1467480863DR. GLEN K STEPHENSON D.M.D.
Individual
Dentist (General Practice)7480 NORTHVIEW ST
BOISE, ID 83704
(208) 375-4041