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General NPI Number Information
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NPI Number | 1073713871
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Entity Type | Individual
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Provider Name | DANIELLE RENEE LEBLANC DDS
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Gender | Female
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Dates
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Enumeration Date | 07/19/2007
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Last Update Date | 04/24/2024
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Provider Practice Location Address
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Address Line | 6111 W NOBLE ST
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City | ROGERS
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State | AR
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Zip | 72758-1412
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Country | US
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Telephone | 479-295-0947
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Fax |
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Provider Business Mailing Address
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Address Line | 1805 QUARRY RIDGE PL NW APT 316
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City | ROCHESTER
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State | MN
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Zip | 55901-0879
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Country | US
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Telephone | 479-685-5585
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | D14117
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License Number State | MN
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