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General NPI Number Information
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NPI Number | 1255436069
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Entity Type | Organization
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Legal Business Name | LEANNE L. MCDONALD, D.M.D, P.C.
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Dates
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Enumeration Date | 09/14/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 325 E PUSHMATAHA ST
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City | BUTLER
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State | AL
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Zip | 36904-2533
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Country | US
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Telephone | 205-459-5535
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Fax |
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Provider Business Mailing Address
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Address Line | 325 E PUSHMATAHA ST
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City | BUTLER
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State | AL
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Zip | 36904-2533
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Country | US
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Telephone | 205-459-5535
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LEANNE L. MCDONALD
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Credential | D.M.D.
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Telephone | 205-459-5535
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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 | 4801
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License Number State | AL
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