Individual
ANTHONY GERARD LEISURE JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
11941 MANCHESTER RD, DES PERES, MO 63131-4502
(314) 501-8300
Mailing address
938 CASTLE PINES DR, BALLWIN, MO 63021-4475
(314) 707-7608
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2026000064
MO
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/01/2024
Last updated
03/24/2026
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