MEDICARE: THOMAS MICHAEL LEONARD D.M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	12586	MA

General Provider Information

NPI Number	:	1003817727
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THOMAS MICHAEL LEONARD D.M.D.

Provider Business Mailing Address
First Line	:	366 MASS AVE
Second Line	:	SUITE 301
City	:	ARLINGTON
State	:	MA
Zip	:	02474-6733
Country	:	US
Telephone Number	:	781-646-8609
Fax Number	:

Provider Business Practice Location Address
First Line	:	366 MASS AVE
Second Line	:	SUITE 301
City	:	ARLINGTON
State	:	MA
Zip	:	02474-6733
Country	:	US
Telephone Number	:	781-646-8609
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/03/2005
Last Update Date	:	07/08/2007

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