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General NPI Number Information
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NPI Number | 1720296684
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Entity Type | Organization
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Legal Business Name | BIAGIO M. LEPRE DDS PC
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Dates
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Enumeration Date | 05/21/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 554 LARKFIELD RD STE 201
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City | EAST NORTHPORT
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State | NY
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Zip | 11731-4205
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Country | US
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Telephone | 631-368-8585
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Fax | 631-486-2169
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Provider Business Mailing Address
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Address Line | 554 LARKFIELD RD STE 201
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City | EAST NORTHPORT
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State | NY
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Zip | 11731-4205
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Country | US
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Telephone | 631-368-8585
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Fax | 631-486-2169
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BIAGIO M LEPRE
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Credential | DDS
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Telephone | 631-368-8585
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 044508
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License Number State | NY
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