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Provider Information for 1548209190

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

DR. FRED H PECK D.D.S.

Gender: MALE

Individual NPI: 1548209190

Calendar   Last Updated:  2012-12-21
  Certification Date: 

Details

Name Value
NPI 1548209190
Enumeration Date 2006-06-06
NPI Type 1 - Individual
Sole Proprietor YES
Status Active
Mailing Address 8251 CORNELL RD SUITE130
CINCINNATI, OH 45249-2286
United States

Phone: 513-621-7666 | Fax: 513-621-7672
View Map External Link
Primary Practice Address 8251 CORNELL RD SUITE130
CINCINNATI, OH 45249-2286
United States

Phone: 513-621-7666 | Fax: 513-621-7672
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 122300000X - Dentist OH 017946