Provider Demographics
NPI:1669510970
Name:DONALD R LEPERE DDS PS
Entity Type:Organization
Organization Name:DONALD R LEPERE DDS PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT CEO
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:LEPERE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:360-275-2855
Mailing Address - Street 1:PO BOX 40
Mailing Address - Street 2:
Mailing Address - City:BELFAIR
Mailing Address - State:WA
Mailing Address - Zip Code:98528
Mailing Address - Country:US
Mailing Address - Phone:360-275-2855
Mailing Address - Fax:360-275-9536
Practice Address - Street 1:22921 NE STATE ROUTE
Practice Address - Street 2:3
Practice Address - City:BELFAIR
Practice Address - State:WA
Practice Address - Zip Code:98528
Practice Address - Country:US
Practice Address - Phone:360-275-2855
Practice Address - Fax:360-275-9536
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE00043661223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty