Healthcare Provider Details

I. General information

NPI: 1518285808
Provider Name (Legal Business Name): CURRY H. LEAVITT DMD,MS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/11/2010
Last Update Date: 05/11/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7475 W SAHARA AVE 101
LAS VEGAS NV
89117-2867
US

IV. Provider business mailing address

7475 W SAHARA AVE 101
LAS VEGAS NV
89117-2867
US

V. Phone/Fax

Practice location:
  • Phone: 484-868-0517
  • Fax:
Mailing address:
  • Phone: 484-868-0517
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number6022
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: