Individual
DR. ORVIN JACOB LEIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
18 DIVISION ST WEST, ELBOW LAKE, MN 56531-1032
(218) 685-4710
(218) 685-6837
Mailing address
18 DIVISION WEST, PO BOX 1032, ELBOW LAKE, MN 56531-1032
(218) 685-4710
(218) 685-6837
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8946
MN
Other
Enumeration date
11/18/2006
Last updated
07/08/2007
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