Provider Demographics
NPI:1093408312
Name:LEBRECHT, JESSE (DMD)
Entity Type:Individual
Prefix:
First Name:JESSE
Middle Name:
Last Name:LEBRECHT
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 1:1910 SE 18TH AVE
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-8312
Mailing Address - Country:US
Mailing Address - Phone:352-732-8544
Mailing Address - Fax:352-732-6855
Practice Address - Street 1:1910 SE 18TH AVE
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-8312
Practice Address - Country:US
Practice Address - Phone:352-732-8544
Practice Address - Fax:352-732-6855
Is Sole Proprietor?:No
Enumeration Date:2023-06-01
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN27980122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist