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General NPI Number Information
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NPI Number | 1235702580
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Entity Type | Individual
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Provider Name | NICHOLAS ALLEN LAPERE RDH
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Gender | Male
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Dates
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Enumeration Date | 07/22/2021
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Last Update Date | 07/22/2021
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Provider Practice Location Address
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Address Line | 26650 EUREKA RD
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City | TAYLOR
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State | MI
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Zip | 48180-4835
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Country | US
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Telephone | 313-561-5100
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Fax |
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Provider Business Mailing Address
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Address Line | 1360 MAR ANN DR
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City | WESTLAND
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State | MI
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Zip | 48186-5339
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Country | US
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Telephone | 734-564-0472
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | 2902019882
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License Number State | MI
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