Individual
DR. JOHN WILLIAM LECLAIR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
1315 WEST COLLEGE AVE., SUITE 201, STATE COLLEGE, PA 16801
(814) 954-7620
(814) 308-9985
Mailing address
1315 WEST COLLEGE AVE., SUITE 201, STATE COLLEGE, PA 16801
(814) 954-7620
(814) 237-3062
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS017092L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1010324310001
—
PA
Enumeration date
03/02/2007
Last updated
12/29/2016
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