Provider Demographics
NPI:1083118483
Name:LEPOWSKY, MATTHEW GLENN (DMD)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:GLENN
Last Name:LEPOWSKY
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 E GRANBY RD
Mailing Address - Street 2:
Mailing Address - City:GRANBY
Mailing Address - State:CT
Mailing Address - Zip Code:06035-2201
Mailing Address - Country:US
Mailing Address - Phone:860-653-7596
Mailing Address - Fax:
Practice Address - Street 1:26 E GRANBY RD
Practice Address - Street 2:
Practice Address - City:GRANBY
Practice Address - State:CT
Practice Address - Zip Code:06035-2201
Practice Address - Country:US
Practice Address - Phone:860-653-7596
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-20
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT124051223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice