MEDICARE: DR. MARJORIE BETH LEOF DMD

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	DS024360L	PA

General Provider Information

NPI Number	:	1437233640
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARJORIE BETH LEOF DMD

Provider Business Mailing Address
First Line	:	55 OLD CLAIRTON RD
Second Line	:	SUITE 3
City	:	PITTSBURGH
State	:	PA
Zip	:	15236-3904
Country	:	US
Telephone Number	:	412-655-4470
Fax Number	:	412-655-4471

Provider Business Practice Location Address
First Line	:	55 OLD CLAIRTON RD
Second Line	:	SUITE 3
City	:	PITTSBURGH
State	:	PA
Zip	:	15236-3904
Country	:	US
Telephone Number	:	412-655-4470
Fax Number	:	412-655-4471

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

Provider Enumeration Date	:	10/24/2006
Last Update Date	:	07/08/2007

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