MEDICARE: DR. FRANCISCO RENE LEAL D.D.S.

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		IL

General Provider Information

NPI Number	:	1376536755
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FRANCISCO RENE LEAL D.D.S.

Provider Business Mailing Address
First Line	:	8320 TOLL HOUSE RD
Second Line	:
City	:	ANNANDALE
State	:	VA
Zip	:	22003-4628
Country	:	US
Telephone Number	:	703-503-1988
Fax Number	:

Provider Business Practice Location Address
First Line	:	1016 BUCHANAN ST SE
Second Line	:	BRANCH HEALTH CLINIC, WASHINGTON NAVY YARD
City	:	WASHINGTON NAVY YARD
State	:	DC
Zip	:	20374-5020
Country	:	US
Telephone Number	:	202-433-2480
Fax Number	:	202-433-0502

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

Provider Enumeration Date	:	08/31/2005
Last Update Date	:	07/08/2007

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