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NPI Code Detail

MEDICARE: DR. LESLIE ALLEN CHRISTIAN DDS

MEDICARE: DR. LESLIE ALLEN CHRISTIAN DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist0401008131VA

General Provider Information

NPI Number : 1134105992
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LESLIE ALLEN CHRISTIAN DDS
Provider Business Mailing Address
First Line : 3664 BRANNON DR
Second Line :
City : VIRGINIA BEACH
State : VA
Zip : 23456-6909
Country : US
Telephone Number : 757-471-2474
Fax Number :
Provider Business Practice Location Address
First Line : 1550 TOMCAT BLVD
Second Line : SUITE100
City : VIRGINIA BEACH
State : VA
Zip : 23460-2218
Country : US
Telephone Number : 757-314-7190
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/22/2005
Last Update Date : 07/08/2007

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