Organization
PEDIATRIC DENTISTRY, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN R LEONARD DDS (OWNER)
(307) 778-7100
Entity
Organization
Contact information
Practice address
1439 STILLWATER AVE STE 7, CHEYENNE, WY 82009-7367
(307) 778-7100
(307) 778-2824
Mailing address
1439 STILLWATER AVE STE 7, CHEYENNE, WY 82009-7367
(307) 778-7100
(307) 778-2824
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
974672
UNITED CONCORDIA CO
WY
Enumeration date
11/09/2006
Last updated
08/22/2020
Update your record
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