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General NPI Number Information
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NPI Number | 1467509737
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Entity Type | Individual
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Provider Name | DAVID MICHAEL REPASKY D.D.S., M.P.H.
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Gender | Male
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Dates
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Enumeration Date | 01/05/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 33030 VAN BORN RD
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City | WAYNE
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State | MI
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Zip | 48184-2453
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Country | US
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Telephone | 734-727-7050
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Fax | 734-727-7005
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Provider Business Mailing Address
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Address Line | 709 CAMBRIDGE ST
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City | YPSILANTI
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State | MI
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Zip | 48197-2127
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Country | US
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Telephone | 734-483-3585
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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 | 1223D0001X
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Taxonomy Name | Public Health Dentistry
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License Number | 2901010538
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License Number State | MI
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