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Individual
DAVID GEORGE LEIBOLD
Active
Individual
DAVID GEORGE LEIBOLD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS MD
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
9735
TX
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
E4478
TX
Other
Enumeration date
08/09/2005
Last updated
07/20/2009
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