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General NPI Number Information
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NPI Number | 1598573792
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Entity Type | Organization
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Legal Business Name | LEU DENTAL, PLLC
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Dates
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Enumeration Date | 12/20/2024
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Last Update Date | 04/29/2025
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Provider Practice Location Address
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Address Line | 3820 STATE HWY 31 W
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City | CORSICANA
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State | TX
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Zip | 75110
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Country | US
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Telephone | 903-603-7044
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 70887
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City | CLEVELAND
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State | OH
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Zip | 44190-0887
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PROVIDER ENROLLMENT TEAM LEAD
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Name | KIA WILLIAMS
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Credential |
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Telephone | 315-454-6000
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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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