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General NPI Number Information
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NPI Number | 1467725739
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Entity Type | Individual
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Provider Name | CARLOS Y LEAL DDS
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Gender | Male
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Dates
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Enumeration Date | 02/17/2012
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Last Update Date | 02/17/2012
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Provider Practice Location Address
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Address Line | 659 E 15 ST SUITE B
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City | UPLAND
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State | CA
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Zip | 91786
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Country | US
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Telephone | 909-946-8304
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Fax | 909-946-8394
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Provider Business Mailing Address
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Address Line | 659 E. 15 ST SUITE B
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City | UPLAND
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State | CA
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Zip | 91786
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Country | US
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Telephone | 909-946-8304
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Fax | 909-946-8394
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | DT32249
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License Number State | CA
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