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NPI Code Detail

MEDICARE: DR. LARRY W LEDDY DDS MS

MEDICARE:  DR. LARRY W LEDDY  DDS MS
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
11223X0400XOrthodontics and Dentofacial Orthopedics Dentistry9070MI

General Provider Information

NPI Number : 1144254160
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LARRY W LEDDY DDS MS
Provider Business Mailing Address
First Line : 5355 COLONY DRIVE NORTH
Second Line :
City : SAGINAW
State : MI
Zip : 48638-7190
Country : US
Telephone Number : 989-792-7056
Fax Number : 989-792-5031
Provider Business Practice Location Address
First Line : 5355 COLONY DRIVE NORTH
Second Line :
City : SAGINAW
State : MI
Zip : 48638-7190
Country : US
Telephone Number : 989-792-7056
Fax Number : 989-792-5031
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/10/2006
Last Update Date : 07/08/2007

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Directions to “ DR. LARRY W LEDDY DDS MS” Practice Location

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