Individual
LEANNE MCCARRON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
3401 N BROAD ST, PHILADELPHIA, PA 19140-5103
(800) 836-7536
Mailing address
4766 MANAYUNK AVE, PHILADELPHIA, PA 19128-4619
(610) 547-4062
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS043529
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/23/2018
Last updated
06/07/2022
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