Jerry Dwayne Leavins DDS

NPI 1679623052 - Dentist - 1223G0001X

NPI Details
NPI 1679623052
Gender Male
Enumeration Date 01/10/2007
Last Updated 07/08/2007
Entity Type Individual
Active Over 10 years ago
Practice Location
180 W BOLIVAR ST
VIDOR TX, 77662-4849, US
Phone (409) 769-5438
Fax (409) 769-2849
Business Location
180 WEST BOLIVAR ST
VIDOR TX, 77662-4849, US
Phone (409) 769-5438
Fax (409) 769-2849
Toxanomy
Taxonomy Code 1223G0001X
License State Texas
License Number 10901
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According to our database, Dr. Jerry Dwayne Leavins DDS NPI is 1679623052, taxonomy code is 1223G0001X and license number is 10901, license state is located at Texas. Jerry Dwayne Leavins DDS physically located at 180 W Bolivar St, Vidor TX, 77662-4849. NPI Number Jerry Dwayne Leavins DDS has the Individual type.

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1679623052 NPI number is provided on an as is basis without warranty of any kind. 1679623052 is maintained by the National Plan & Provider Enumeration System. The contents of Jerry Dwayne Leavins DDS are for informational purposes only.