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General NPI Number Information
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NPI Number | 1174474019
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Entity Type | Organization
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Legal Business Name | LP DENTAL
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Dates
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Enumeration Date | 02/06/2026
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Last Update Date | 02/06/2026
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Provider Practice Location Address
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Address Line | 50202 SCHOENHERR RD
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City | SHELBY TOWNSHIP
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State | MI
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Zip | 48315-3134
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Country | US
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Telephone | 586-226-2700
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Fax |
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Provider Business Mailing Address
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Address Line | 16267 ADELAIDE DR
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City | MACOMB
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State | MI
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Zip | 48044-1557
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Country | US
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Telephone | 586-907-6537
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Fax |
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Authorized Official
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Title or Position | OWNER/DENTIST
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Name | LUCIO PERSICHETTI
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Credential | DDS
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Telephone | 586-907-6537
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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