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Organization
LEAH THOMPSON GAGNON, D.M.D, P.A.
Active
Organization
LEAH THOMPSON GAGNON, D.M.D, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LEAH THOMPSON GAGNON D.M.D. (DOCTOR OF DENTAL MEDICINE)
(850) 897-1100
Entity
Organization
Contact information
Practice address
4550 HIGHWAY 20 EAST, SUITE C, NICEVILLE, FL 32578
(850) 897-1100
Mailing address
4550 HIGHWAY 20 EAST, SUITE C, NICEVILLE, FL 32578
(850) 897-1100
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN 17297
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1235273392
NPI TYPE 1
FL
Enumeration date
12/06/2006
Last updated
01/25/2010
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