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General NPI Number Information
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NPI Number | 1568550895
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Entity Type | Organization
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Legal Business Name | STEVEN A. LEACH,DMD,PC
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Dates
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Enumeration Date | 10/11/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2002 FLINT RD SE
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City | DECATUR
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State | AL
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Zip | 35601-6021
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Country | US
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Telephone | 256-353-3211
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Fax | 256-353-4345
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Provider Business Mailing Address
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Address Line | 2002 FLINT RD SE
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City | DECATUR
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State | AL
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Zip | 35601-6021
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Country | US
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Telephone | 256-353-3211
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Fax | 256-353-4345
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. STEVEN ALEXANDER LEACH
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Credential | DMD
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Telephone | 256-353-3211
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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 | 3348
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License Number State | AL
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