Provider Demographics
NPI:1619068566
Name:LAURENCE M TEPPER D.D.S.P.C.
Entity Type:Organization
Organization Name:LAURENCE M TEPPER D.D.S.P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURENCE
Authorized Official - Middle Name:M
Authorized Official - Last Name:TEPPER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:212-717-7710
Mailing Address - Street 1:35 E 85TH ST
Mailing Address - Street 2:1N
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-0954
Mailing Address - Country:US
Mailing Address - Phone:212-717-7710
Mailing Address - Fax:
Practice Address - Street 1:35 E 85TH ST
Practice Address - Street 2:1N
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-0954
Practice Address - Country:US
Practice Address - Phone:212-717-7710
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0286801223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty