# NICK LEONE DDS PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043568694
- **Authorized official:** NICK LEONE (CORPORATE OFFICER)
- **Authorized official phone:** (586) 775-7750

## Contact information

- **Practice address:** 28018 HARPER AVE., ST. CLAIR SHORES, MI 48081-1562
- **Practice address phone:** (586) 775-7750
- **Mailing address:** 28018 HARPER AVE., ST. CLAIR SHORES, MI 48081-1562

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 2901013480 | MI | Yes |

## Other

- **Enumeration date:** 08/29/2012
- **Last updated:** 08/29/2012