Individual
DR. LEO PRUSINSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
2005 KNIGHT LANE NAVY MEDICINE SUPPORT COMMAND, ATTN: MEDICAL STAFF SERVICES BLDG. H, JACKSONVILLE, FL 32212-0140
(904) 542-7200
Mailing address
2005 KNIGHT LANE NAVY MEDICINE SUPPORT COMMAND, ATTN: MEDICAL STAFF SERVICES BLDG. H, JACKSONVILLE, FL 32212-0140
(904) 542-7200
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12008653A
IN
Other
Enumeration date
03/07/2006
Last updated
02/04/2010
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