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General NPI Number Information
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NPI Number | 1326235904
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Entity Type | Individual
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Provider Name | LUCY J OPRIS D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 09/27/2007
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Last Update Date | 04/08/2021
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Provider Practice Location Address
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Address Line | 2790 12 MILE RD
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City | BERKLEY
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State | MI
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Zip | 48072-1630
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Country | US
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Telephone | 248-439-0088
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Fax | 248-439-2900
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Provider Business Mailing Address
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Address Line | 2790 12 MILE RD
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City | BERKLEY
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State | MI
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Zip | 48072-1630
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Country | US
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Telephone | 248-439-0088
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Fax | 248-439-2900
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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 | 1223D0001X
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Taxonomy Name | Public Health Dentistry
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License Number | 019027489
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 2901022416
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 1223D0001X
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Taxonomy Name | Public Health Dentistry
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License Number | 2901022416
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License Number State | MI
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