Individual
DR. JERRY LEE LEONARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
985 RUSSELL AVE, GAITHERSBURG, MD 20879-6211
(301) 926-2928
Mailing address
985 RUSSELL AVE, GAITHERSBURG, MD 20879-6211
(301) 926-2928
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
17407
MD
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
5488
OK
Other
Enumeration date
10/02/2006
Last updated
10/22/2021
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