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General NPI Number Information
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NPI Number | 1083098230
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Entity Type | Individual
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Provider Name | KELLY LEACH
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Gender | Female
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Dates
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Enumeration Date | 07/17/2015
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Last Update Date | 03/05/2026
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Provider Practice Location Address
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Address Line | 9138 ARLON ST
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City | ANCHORAGE
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State | AK
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Zip | 99507-3876
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Country | US
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Telephone | 907-222-2483
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Fax |
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Provider Business Mailing Address
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Address Line | 10000 CRAIG CREEK CIR
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City | ANCHORAGE
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State | AK
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Zip | 99507-6905
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Country | US
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Telephone | 480-228-9562
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 135678
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License Number State | AK
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