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General NPI Number Information
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NPI Number | 1336577717
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Entity Type | Organization
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Legal Business Name | LEONARD J FELD,DDS, INC.
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Dates
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Enumeration Date | 10/23/2013
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Last Update Date | 10/23/2013
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Provider Practice Location Address
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Address Line | 4332 SLAUSON AVE
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City | MAYWOOD
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State | CA
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Zip | 90270-2848
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Country | US
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Telephone | 323-771-7777
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Fax | 323-562-5209
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Provider Business Mailing Address
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Address Line | 4332 SLAUSON AVE
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City | MAYWOOD
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State | CA
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Zip | 90270-2848
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Country | US
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Telephone | 323-771-7777
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Fax | 323-562-5209
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Authorized Official
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Title or Position | OWNER/DENTIST
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Name | DR. LEONARD JACK FELD
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Credential | DDS
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Telephone | 323-771-7777
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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 | 24774
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License Number State | CA
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