Provider Demographics
NPI:1558410290
Name:LAEUPPLE, LEE DENNIS (DDS)
Entity Type:Individual
Prefix:DR
First Name:LEE
Middle Name:DENNIS
Last Name:LAEUPPLE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2534
Mailing Address - Street 2:
Mailing Address - City:HAVRE
Mailing Address - State:MT
Mailing Address - Zip Code:59501-2534
Mailing Address - Country:US
Mailing Address - Phone:406-265-1790
Mailing Address - Fax:
Practice Address - Street 1:35 3RD ST
Practice Address - Street 2:
Practice Address - City:HAVRE
Practice Address - State:MT
Practice Address - Zip Code:59501-3553
Practice Address - Country:US
Practice Address - Phone:406-265-1790
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT17281223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice