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Individual

DAVID GEORGE LEIBOLD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS MD

Contact information

Practice address
7703 FLOYD CURL DR, SAN ANTONIO, TX 78229-3901
(210) 567-3477
(210) 567-3900
Mailing address
7703 FLOYD CURL DR, SAN ANTONIO, TX 78229-3901
(210) 567-3472
(210) 567-2995

Taxonomy

Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
9735
TX
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
E4478
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
137233610
MEDICAL DENTAL
TX
05
137233611
TX
Enumeration date
08/09/2005
Last updated
07/20/2009
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