Individual
TRACI LEON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
2812 W HEFNER RD, OKLAHOMA CITY, OK 73120-6318
(405) 751-0358
Mailing address
2812 W HEFNER RD, OKLAHOMA CITY, OK 73120-6318
(405) 751-0358
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6796
OK
Other
Enumeration date
10/15/2016
Last updated
02/20/2020
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