Organization
CROSS CREEK DENTAL CARE - MOUNT VERNON,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES T LEON DDS (OWNER)
(740) 725-8000
Entity
Organization
Contact information
Practice address
214 E CHESTNUT ST, MOUNT VERNON, OH 43050-3447
(740) 725-8000
Mailing address
214 E CHESTNUT ST, MOUNT VERNON, OH 43050-3447
(740) 725-8000
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
18705
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BL1311531
X RAY REGISTRATION
OH
Enumeration date
12/06/2012
Last updated
12/18/2012
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