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General NPI Number Information
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NPI Number | 1932296167
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Entity Type | Organization
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Legal Business Name | DR LEON A CERNIWAY, DMD, PC
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Dates
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Enumeration Date | 10/09/2006
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Last Update Date | 12/08/2009
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Provider Practice Location Address
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Address Line | 680 KINGSBOROUGH SQUARE SUITE A
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City | CHESAPEAKE
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State | VA
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Zip | 23320-4988
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Country | US
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Telephone | 757-547-9339
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Fax | 757-547-3433
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Provider Business Mailing Address
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Address Line | 680 KINGSBOROUGH SQUARE SUITE A
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City | CHESAPEAKE
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State | VA
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Zip | 23320-4988
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Country | US
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Telephone | 757-547-9339
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Fax | 757-547-3433
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Authorized Official
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Title or Position | PRESIDENT
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Name | LEON A CERNIWAY
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Credential | D.M.D.
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Telephone | 757-547-9339
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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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