MEDICARE: DR. ALEX LEBEL DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	045645	NY

General Provider Information

NPI Number	:	1649316597
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALEX LEBEL DDS

Provider Business Mailing Address
First Line	:	1912 AVENUE U
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11229-3906
Country	:	US
Telephone Number	:	718-648-3434
Fax Number	:	718-648-1515

Provider Business Practice Location Address
First Line	:	1912 AVENUE U
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11229-3906
Country	:	US
Telephone Number	:	718-648-3434
Fax Number	:	718-648-1515

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/29/2007
Last Update Date	:	07/08/2007

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