Provider Demographics
NPI:1720296684
Name:BIAGIO M. LEPRE DDS PC
Entity Type:Organization
Organization Name:BIAGIO M. LEPRE DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BIAGIO
Authorized Official - Middle Name:M
Authorized Official - Last Name:LEPRE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:631-368-8585
Mailing Address - Street 1:554 LARKFIELD RD STE 201
Mailing Address - Street 2:
Mailing Address - City:EAST NORTHPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11731-4205
Mailing Address - Country:US
Mailing Address - Phone:631-368-8585
Mailing Address - Fax:631-486-2169
Practice Address - Street 1:554 LARKFIELD RD STE 201
Practice Address - Street 2:
Practice Address - City:EAST NORTHPORT
Practice Address - State:NY
Practice Address - Zip Code:11731-4205
Practice Address - Country:US
Practice Address - Phone:631-368-8585
Practice Address - Fax:631-486-2169
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0445081223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty