MEDICARE: DR. LESLIE CELESTINA DDS PA

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	122300000X	Dentist	DN15545	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1801085550
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LESLIE CELESTINA DDS PA

Provider Business Mailing Address
First Line	:	5601 US HIGHWAY 27 N
Second Line	:
City	:	SEBRING
State	:	FL
Zip	:	33870-1212
Country	:	US
Telephone Number	:	863-382-4894
Fax Number	:	863-382-6715

Provider Business Practice Location Address
First Line	:	5601 US HIGHWAY 27 N
Second Line	:
City	:	SEBRING
State	:	FL
Zip	:	33870-1212
Country	:	US
Telephone Number	:	863-382-4894
Fax Number	:	863-382-6715

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

Provider Enumeration Date	:	10/18/2007
Last Update Date	:	12/03/2008

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