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General NPI Number Information
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NPI Number | 1588381727
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Entity Type | Organization
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Legal Business Name | ERIC S. LEITHNER, DMD, PC
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Dates
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Enumeration Date | 10/27/2022
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Last Update Date | 10/27/2022
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Provider Practice Location Address
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Address Line | 107 VALLEY RUN DR.
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City | BREMEN
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State | GA
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Zip | 30110
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Country | US
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Telephone | 770-537-9656
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Fax |
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Provider Business Mailing Address
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Address Line | 107 VALLEY RUN DR.
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City | BREMEN
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State | GA
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Zip | 30110
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Country | US
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Telephone | 770-537-9656
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Fax |
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Authorized Official
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Title or Position | CEO/DENTIST
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Name | MR. ERIC SEAN LEITHNER
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Credential | D.M.D.
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Telephone | 770-855-2904
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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 |
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License Number State |
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