Individual
MRS. SUSAN LEARY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
3020 CHILDREN'S WAY MC#5127, SAN DIEGO, CA 92123-4223
(858) 966-4094
(858) 966-8097
Mailing address
276 B AVE, CORONADO, CA 92118-1975
(858) 966-4094
(858) 966-8097
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
53671
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
D53671
—
CA
Enumeration date
12/12/2006
Last updated
07/09/2007
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