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General NPI Number Information
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NPI Number | 1437458551
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Entity Type | Organization
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Legal Business Name | M MARK LEPORE DDS, INC
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Dates
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Enumeration Date | 03/16/2011
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Last Update Date | 03/16/2011
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Provider Practice Location Address
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Address Line | 5576 MAYFIELD RD
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City | LYNDHURST
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State | OH
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Zip | 44124-2928
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Country | US
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Telephone | 440-442-2901
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Fax | 440-442-1932
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Provider Business Mailing Address
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Address Line | 5576 MAYFIELD RD
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City | LYNDHURST
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State | OH
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Zip | 44124-2928
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Country | US
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Telephone | 440-442-2901
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Fax | 440-442-1932
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Authorized Official
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Title or Position | OFFICE MANGER
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Name | MRS. GENA MARIE SCHEID
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Credential |
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Telephone | 440-442-2901
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 30.017191
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License Number State | OH
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