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Individual

DR. ELLIOT IVAN LEON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
1005 DUNN RD, FLORISSANT, MO 63031-8205
(314) 838-9454
(314) 838-9414
Mailing address
1005 DUNN RD, FLORISSANT, MO 63031-8205
(314) 838-9454
(314) 838-9414

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
012522
MO
122300000X
Dentist
12522
MO

Other

Enumeration date
10/19/2006
Last updated
07/10/2008
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