Organization
TENNESSEE ENHANCED DENTAL SERVICES LLC
Active
Other names
Jeffrey R Leidy DMD LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY RANDALL LEIDY DMD (PRESIDENT OWNER)
(757) 463-1500
Entity
Organization
Contact information
Practice address
1301 FIRST COLONIAL BLVD, VIRGINIA BEACH, VA 23454
(757) 463-1500
(757) 463-8727
Mailing address
1301 FIRST COLONIAL BLVD (HEADQUARTERS), VIRGINIA BEACH, VA 23454
(757) 463-1500
(757) 463-8727
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401006498
VA
Other
Enumeration date
11/01/2006
Last updated
07/14/2008
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