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NPI 1619030301

NPI 1619030301 : VICTORIA LYNN LEONHART D.D.S. : BOERNE, TX

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General NPI Number Information
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    NPI Number           |    1619030301
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    Entity Type          |    Individual 
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    Provider Name        |    VICTORIA LYNN LEONHART D.D.S.
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    12/18/2006
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    Last Update Date     |    03/02/2015
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Provider Practice Location Address
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    Address Line         |    11345 ALAMO RANCH PKWY STE 104
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    City                 |    BOERNE
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    State                |    TX
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    Zip                  |    78006
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    Country              |    US
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    Telephone            |    210-289-1431
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    11345 ALAMO RANCH PKWY STE 104
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    City                 |    BOERNE
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    State                |    TX
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    Zip                  |    78006
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    Country              |    US
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    Telephone            |    210-289-1431
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    Fax                  |    
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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        |    122300000X
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    Taxonomy Name        |    Dentist
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    License Number       |    28846
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    License Number State |    TX
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