Healthcare Provider Details

I. General information

NPI: 1467095976
Provider Name (Legal Business Name): LEAH MCQUIGG, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/28/2019
Last Update Date: 12/11/2019
Certification Date: 12/11/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15435 GLENEAGLE DR STE 200
COLORADO SPRINGS CO
80921-2542
US

IV. Provider business mailing address

15435 GLENEAGLE DR STE 200
COLORADO SPRINGS CO
80921-2542
US

V. Phone/Fax

Practice location:
  • Phone: 719-481-6788
  • Fax:
Mailing address:
  • Phone: 719-481-6788
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. LEAH MCQUIGG
Title or Position: DDS
Credential: DDS
Phone: 303-476-8478