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Individual

DR. BENJAMIN DAVID LEAVER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
1466 N HIGHWAY 89, SUITE 200, FARMINGTON, UT 84025-2738
(801) 451-7812
(801) 451-8962
Mailing address
1163 SHADOWRIDGE DRIVE, KAYSVILLE, UT 84037
(801) 451-7812
(801) 451-8962

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5351245-9922
UT

Other

Enumeration date
12/08/2006
Last updated
07/08/2007
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