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General NPI Number Information
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NPI Number | 1366673519
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Entity Type | Organization
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Legal Business Name | COMFORT DENTAL ROCKWALL PLLC
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Dates
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Enumeration Date | 08/06/2009
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Last Update Date | 08/06/2009
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Provider Practice Location Address
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Address Line | 515 E I30
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City | ROCKWALL
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State | TX
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Zip | 75087-5408
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Country | US
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Telephone | 214-771-4603
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Fax | 214-771-4610
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Provider Business Mailing Address
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Address Line | 515 E I30
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City | ROCKWALL
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State | TX
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Zip | 75087-5408
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Country | US
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Telephone | 214-771-4603
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Fax | 214-771-4610
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOHN LEINWEBER
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Credential | DMD
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Telephone | 214-771-4603
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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 |
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License Number State |
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