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General NPI Number Information
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NPI Number | 1447385125
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Entity Type | Organization
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Legal Business Name | JOSHUA E LEUTE DDS SC
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Dates
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Enumeration Date | 02/22/2007
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Last Update Date | 03/03/2010
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Provider Practice Location Address
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Address Line | 1317 W GRAND AVENUE
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City | PORT WASHINGTON
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State | WI
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Zip | 53074
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Country | US
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Telephone | 262-284-5884
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Fax | 262-284-1840
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Provider Business Mailing Address
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Address Line | 1317 W GRAND AVENUE
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City | PORT WASHINGTON
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State | WI
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Zip | 53074
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Country | US
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Telephone | 262-284-5884
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Fax | 262-284-1840
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOSHUA E LEUTE
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Credential | DDS
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Telephone | 262-284-5884
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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 | 5000738
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License Number State | WI
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