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General NPI Number Information
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NPI Number | 1174939458
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Entity Type | Organization
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Legal Business Name | PENNY LEONG DMD PLLC
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Dates
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Enumeration Date | 07/07/2014
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Last Update Date | 07/07/2014
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Provider Practice Location Address
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Address Line | 1500 NW MARKET ST SUITE 100
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City | SEATTLE
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State | WA
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Zip | 98107-5211
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Country | US
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Telephone | 206-783-2220
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Fax | 206-783-1119
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Provider Business Mailing Address
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Address Line | 1500 NW MARKET ST SUITE 100
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City | SEATTLE
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State | WA
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Zip | 98107-5211
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Country | US
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Telephone | 206-783-2220
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Fax | 206-783-1119
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Authorized Official
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Title or Position | OWNER/DENTIST
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Name | DR. PENNY MAY LEONG
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Credential | DMD
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Telephone | 206-783-2220
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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 | DE00009675
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License Number State | WA
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