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General NPI Number Information
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NPI Number | 1861572018
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Entity Type | Organization
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Legal Business Name | AWBREY & LEACH, D.D.S., P.C.
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Dates
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Enumeration Date | 10/16/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4895 WINDWARD PKWY SUITE 201
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City | ALPHARETTA
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State | GA
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Zip | 30004-3850
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Country | US
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Telephone | 770-521-8855
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Fax | 770-663-7224
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Provider Business Mailing Address
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Address Line | 4895 WINDWARD PKWY SUITE 201
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City | ALPHARETTA
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State | GA
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Zip | 30004-3850
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Country | US
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Telephone | 770-521-8855
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Fax | 770-663-7224
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MICHAEL LEACH
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Credential | D.D.S.
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Telephone | 770-521-8855
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | DN011522
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | DN012732
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License Number State | GA
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