Individual
DR. LEON ROBERT PECK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS, PH.D.
Contact information
Practice address
8500 WILSHIRE BLVD, SUITE 815, BEVERLY HILLS, CA 90211-3121
(310) 657-6363
(310) 652-5785
Mailing address
8500 WILSHIRE BLVD, SUITE 815, BEVERLY HILLS, CA 90211-3121
(310) 657-6363
(310) 652-5785
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
38348
CA
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
38348
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
B38348-01
—
CA
Enumeration date
07/14/2006
Last updated
11/20/2009
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