Provider Demographics
NPI:1275531618
Name:KUPERMAN, LESTER HERMAN (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:LESTER
Middle Name:HERMAN
Last Name:KUPERMAN
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4200 BRYANT IRVIN RD
Mailing Address - Street 2:
Mailing Address - City:BENBROOK
Mailing Address - State:TX
Mailing Address - Zip Code:76109-4287
Mailing Address - Country:US
Mailing Address - Phone:817-731-8401
Mailing Address - Fax:817-377-4317
Practice Address - Street 1:4200 BRYANT IRVIN RD
Practice Address - Street 2:
Practice Address - City:BENBROOK
Practice Address - State:TX
Practice Address - Zip Code:76109-4287
Practice Address - Country:US
Practice Address - Phone:817-731-8401
Practice Address - Fax:817-377-4317
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0092271223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics