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General NPI Number Information
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NPI Number | 1467725879
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Entity Type | Organization
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Legal Business Name | LEIGHTON W WOOD DDS MS P.C.
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Dates
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Enumeration Date | 02/15/2012
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Last Update Date | 10/24/2012
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Provider Practice Location Address
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Address Line | 103 LINDEN SQUARE DRIVE
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City | BRISTOL
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State | VA
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Zip | 24202
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Country | US
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Telephone | 276-642-0043
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Fax | 276-642-0077
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Provider Business Mailing Address
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Address Line | 103 LINDEN SQUARE DRIVE
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City | BRISTOL
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State | VA
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Zip | 24202
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Country | US
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Telephone | 276-642-0043
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Fax | 276-642-0077
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Authorized Official
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Title or Position | OWNER
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Name | DR. LEIGHTON W WOOD
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Credential | DDS, MS
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Telephone | 276-642-0043
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 0401413166
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License Number State | VA
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