Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 23633 | TX |
NPI | 1013178706 |
---|---|
Provider Name | Dr. Casey Renee Lepley |
First Address | Dallas, TX 75205-4226 |
Second Address | Dallas, TX 75211-1382 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2008 |
Last Update Date | 24/06/2008 |