Leonard R Odham Jr Dds Pa

NPI 1063556587 - Dentist - 122300000X

NPI Details
NPI 1063556587
Enumeration Date 02/16/2007
Last Updated 05/29/2012
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name LEONARD RUSSELL LEONARD
Position PRES
Phone (910) 649-7222
Fax (910) 649-7113
Practice Location
16 POWELL ST
FAIR BLUFF NC, 28439, US
Phone (910) 649-7222
Fax (910) 649-7113
Business Location
PO BOX 368
FAIR BLUFF NC, 28439, US
Phone (910) 649-7222
Fax (910) 649-7113
Toxanomy
Taxonomy Code 122300000X
License State North Carolina
License Number 4101
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According to our database, Leonard R Odham Jr Dds Pa NPI is 1063556587, taxonomy code is 122300000X and license number is 4101, license state is located at North Carolina. Leonard R Odham Jr Dds Pa physically located at 16 Powell St, Fair Bluff NC, 28439. NPI Number 1033115704 has the healthcare provider type.

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1063556587 NPI number is provided on an as is basis without warranty of any kind. 1063556587 is maintained by the National Plan & Provider Enumeration System. The contents of Leonard R Odham Jr Dds Pa are for informational purposes only.