# K AND L DENTAL

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

## Provider details

- **NPI number:** 1528139151
- **Authorized official:** DR. CHAD R LEIGHTY (OWNER)
- **Authorized official phone:** (765) 664-0028

## Contact information

- **Practice address:** 117 W MULBERRY ST, MARION, IN 46952-2667
- **Practice address phone:** (765) 664-0028
- **Practice address fax:** (765) 668-3658
- **Mailing address:** 117 W MULBERRY ST, MARION, IN 46952-2667
- **Mailing address phone:** (765) 664-0028
- **Mailing address fax:** (765) 668-3658

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 12009572 | IN | Yes |

## Other

- **Enumeration date:** 11/13/2006
- **Last updated:** 04/07/2008