Healthcare Provider Details
I. General information
NPI: 1790622447
Provider Name (Legal Business Name): LELAND DENTISTRY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/30/2026
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
76 PROSPECT ST
GLOUCESTER MA
01930-3710
US
IV. Provider business mailing address
14 HEATHER DR
READING MA
01867-3959
US
V. Phone/Fax
- Phone: 781-439-5238
- Fax:
- Phone: 781-439-5238
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QD0000X |
| Taxonomy | Dental Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
BRIAN
LELAND
Title or Position: OWNER
Credential: DMD
Phone: 781-439-5238