Provider Demographics
NPI:1710025952
Name:LEPERE, DONALD RICHARD (DDS)
Entity type:Individual
Prefix:DR
First Name:DONALD
Middle Name:RICHARD
Last Name:LEPERE
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 40
Mailing Address - Street 2:
Mailing Address - City:BLEFAIR
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 #3
Practice Address - Street 2:
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
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000043661223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice