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General NPI Number Information
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NPI Number | 1477571610
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Entity Type | Individual
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Provider Name | JOHN REICHMANN LEONARD D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 07/17/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1439 STILLWATER AVE STE 7
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City | CHEYENNE
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State | WY
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Zip | 82009-7367
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Country | US
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Telephone | 307-778-7100
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Fax | 307-778-2824
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Provider Business Mailing Address
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Address Line | 1439 STILLWATER AVE STE 7
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City | CHEYENNE
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State | WY
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Zip | 82009-7367
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Country | US
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Telephone | 307-778-7100
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Fax | 307-778-2824
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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 | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 1058
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License Number State | WY
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