Healthcare Provider Details

I. General information

NPI: 1932235116
Provider Name (Legal Business Name): SALVATORE ANTHONY LEONE DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/24/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10814 19TH AVE SE
EVERETT WA
98208-5153
US

IV. Provider business mailing address

13440 NE 148TH ST
WOODINVILLE WA
98072-4612
US

V. Phone/Fax

Practice location:
  • Phone: 425-337-4734
  • Fax: 425-316-8652
Mailing address:
  • Phone: 425-478-7181
  • Fax: 425-896-8273

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License NumberDE00005903
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: