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NPI Code Detail

MEDICARE: DR. DAVID ARCHIE LEAL DDS

MEDICARE: DR. DAVID ARCHIE LEAL 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
1122300000XDentist16203TX

General Provider Information

NPI Number : 1942280094
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DAVID ARCHIE LEAL DDS
Provider Business Mailing Address
First Line : BUDGE DENTAL CLINIC
Second Line : 3145 GARDEN AVE BLDG 1278
City : FORT SAM HOUSTON
State : TX
Zip : 78234
Country : US
Telephone Number : 210-808-3735
Fax Number : 210-539-2084
Provider Business Practice Location Address
First Line : BUDGE DENTAL CLINIC
Second Line : 3145 GARDEN AVE BLDG 1278
City : FORT SAM HOUSTON
State : TX
Zip : 78234
Country : US
Telephone Number : 210-808-3735
Fax Number : 210-539-2084
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/17/2006
Last Update Date : 11/04/2022

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