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General NPI Number Information
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NPI Number | 1487453254
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Entity Type | Organization
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Legal Business Name | DANNY BLAINE LEEDS DDS
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Dates
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Enumeration Date | 03/12/2025
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Last Update Date | 03/12/2025
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Provider Practice Location Address
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Address Line | 1606 JUANITA LN STE D&G
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City | TIBURON
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State | CA
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Zip | 94920-2548
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Country | US
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Telephone | 415-435-3371
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Fax |
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Provider Business Mailing Address
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Address Line | 1606 JUANITA LN STE D&G
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City | TIBURON
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State | CA
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Zip | 94920-2548
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Country | US
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Telephone | 415-435-3371
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Fax |
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Authorized Official
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Title or Position | OWNER / DENTIST
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Name | DR. DANNY BLAINE LEEDS
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Credential | DDS
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Telephone | 479-754-0459
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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