Individual
LEANDRO PASSOS SOARES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS,MS, PHD
Contact information
Practice address
521 N 11TH ST RM 417, RICHMOND, VA 23298-5016
(804) 828-3368
Mailing address
3905 VILLAGE TOWNES WALK, GLEN ALLEN, VA 23060-5601
(984) 261-6599
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
0411000077
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0411000077
DENTAL FACULTY LICENSE
VA
Enumeration date
07/09/2022
Last updated
07/11/2025
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