Healthcare Provider Details

I. General information

NPI: 1093944241
Provider Name (Legal Business Name): LEANDER SMILES DENTISTRY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2009
Last Update Date: 07/09/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

651 N US HIGHWAY 183 SUITE 150
LEANDER TX
78641-8990
US

IV. Provider business mailing address

651 N US HIGHWAY 183 SUITE 150
LEANDER TX
78641-8990
US

V. Phone/Fax

Practice location:
  • Phone: 512-260-0123
  • Fax: 512-260-0110
Mailing address:
  • Phone: 512-260-0123
  • Fax: 512-260-0110

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number14486
License Number StateTX

VIII. Authorized Official

Name: DR. PAUL DABNEY
Title or Position: OWNER/ DENTIST
Credential: D.D.S.
Phone: 512-260-0123