Individual
DR. LEONARD RAY FUQUA JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS, MS
Contact information
Practice address
505 N KENTUCKY ST, KINGSTON, TN 37763-2630
(865) 376-4445
(865) 376-4441
Mailing address
505 N KENTUCKY ST, KINGSTON, TN 37763-2630
(865) 376-4445
(865) 376-4441
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DS0000002917
TN
Other
Enumeration date
11/10/2005
Last updated
07/05/2011
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