Provider Demographics
NPI:1558494351
Name:LEPRI, DANIEL A (DDS)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:A
Last Name:LEPRI
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 1:27730 GRATIOT AVE
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48066-4838
Mailing Address - Country:US
Mailing Address - Phone:586-771-6440
Mailing Address - Fax:586-771-6905
Practice Address - Street 1:27730 GRATIOT AVE
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:MI
Practice Address - Zip Code:48066-4838
Practice Address - Country:US
Practice Address - Phone:586-771-6440
Practice Address - Fax:586-771-6905
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI138911223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice